Care for Each Other. Stimulating Fellow Care in sheltered housing for homeless people.

Studies show that the continuity in the chain of services for homeless people in the Netherlands is suboptimal. Too few clients of day and night shelters make use of supplementary services, while staff hesitate to refer clients to these services. New housing and care projects are being developed but evidence-based working methodologies for working with this complex target group are largely absent.


Although not always visible in the world of homelessness, homeless often support one another in various ways. On the street you may not be friends, but mutual support and exchanges are quite common. When professional help is out of reach and at moments of crisis, the homeless have to make due with one another. Within their networks find understanding (fellow feeling), support and protection. Such 'Fellow Care' could offer an important starting point for social support, but is barely used within homeless care and shelter facilities.


The concept of fellow care (caring for each other) is central to the proposed strategic study. The goal is to develop and transfer knowledge about fellow care to homeless care workers and to involve the client population into this process. The fellow care intervention stimulates existing (latent) care intentions among the participants and will be directed towards supporting reaching (individual and collective) care and treatment targets. Towards this objective, a Peer Driven intervention (PDI) will be implemented, based on the theory of Group Mediated Social Control, which hypothesizes that behaviour change is established not merely through one-on-one relations but also, and primarily, through social influence in peer groups. The planned PDI uses a structured system of incentives that aims to stimulate participants to support each other in reaching individual and collective care and treatment goals, with the goal of preventing/reducing drop out from the sheltered housing facility and improve the flow in the care and treatment chain.


Towards the implementation of the intervention and trial, a collaborative agreement has been established between the Utrecht Addiction Research Center (CVO), JellinekMentrum (Arkin) en HVO Querido (both in Amsterdam), the Technical University (Hogeschool) Utrecht and the Basisberaad Rijnmond (client advocacy). The PDI will be implemented by JellinekMentrum staff (ACT/bemoeizorgteams) in two sheltered housing (MO) facilities of HVO Querido. A (preliminary) project group has been established with representatives of the participating organisations.

Compared to standard care, Peer Driven Fellow Care combined with standard care will result in significantly less drop out and improved flow in the social rehabilitation process for homeless people, as well as in significant improvements in participant autonomy in the areas of housing, employment, health, quality of life and other treatment and care goals.

Five measurements:

Baseline, month 2, month 4; month 10 and month 22 after enrolment into the study.

The standard intervention includes support and care services of the participating sheltered housing facilities (HVO-Querido, Amsterdam) and Assertive Community Treatment provided by Jellinek-Mentrum.

In addition to the standard care, the experimental intervention includes participation in a peer-driven support group, working on mutual social support in triads, and the use of group-mediated incentives in support of treatment and care goals.