RESUMEN
According to recent legislation, support provided by local authorities in the Netherlands ought to be strengths-based and empower inhabitants to gain control over their lives. This study examined the outcomes, critical elements and working mechanisms of Pathways to Empowerment (PTE), a person-centered, strengths-based intervention, in local social support services provided by a medium size Dutch local authority, from the perspective of citizens needing support. A year after implementation of PTE, semi-structured face-to-face interviews were held with 17 citizens onto their experiences with the provided support with PTE, inquiring their experiences with certain principles of PTE and the changes the support has brought into their lives. The outcomes of support with PTE were: resilience, self-consciousness, positive connections and access to resources and services. According to citizens, 'being there', an empowering approach, listening and taking them seriously, focusing on strengths and qualities, working on naturally occurring resources and made-to-measure support is what makes support with PTE work. Working mechanisms connecting the critical elements with the reported outcomes were: building trust and rapport in the client-professional relationship, stimulating trust in and empowerment of self, stimulating social trust and awareness of naturally occurring resources, as well as support, guidance and mediation. The results of this study can help local authorities to better substantiate their choice for applying strengths-based interventions, like PTE, in local social support services.
Asunto(s)
Apoyo Social , Servicio Social , Humanos , Empoderamiento , Emociones , Países BajosRESUMEN
In this study, linear mixed-effects regression analyses were used to examine whether sociodemographic variables, abuse-related variables, and well-being variables were associated with symptoms of depression and post-traumatic stress disorder (PTSD) in abused women residing in shelters. Results pointed out that symptoms of depression severity were positively associated with migration background and the experience of physical abuse and negatively associated with self-esteem and social support. PTSD symptoms were positively associated with the experience of sexual abuse and negatively associated with self-esteem. Within women's shelters, staff could be sensitive to improving the social integration of women, especially those with a non-Dutch background, and strengthening the women's social networks and their self-esteem.
Asunto(s)
Mujeres Maltratadas/psicología , Depresión/clasificación , Violencia de Pareja/psicología , Trastornos por Estrés Postraumático/clasificación , Adolescente , Adulto , Mujeres Maltratadas/estadística & datos numéricos , Víctimas de Crimen/clasificación , Víctimas de Crimen/psicología , Víctimas de Crimen/estadística & datos numéricos , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Violencia de Pareja/estadística & datos numéricos , Persona de Mediana Edad , Países Bajos/epidemiología , Autoeficacia , Apoyo Social , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicologíaRESUMEN
OBJECTIVES: To examine the effectiveness of critical time intervention (CTI)-an evidence-based intervention-for abused women transitioning from women's shelters to community living. METHODS: A randomized controlled trial was conducted in nine women's shelters across the Netherlands. 136 women were assigned to CTI (n = 70) or care-as-usual (n = 66). Data were analyzed using intention-to-treat three-level mixed-effects models. RESULTS: Women in the CTI group had significant fewer symptoms of post-traumatic stress (secondary outcome) (adjusted mean difference - 7.27, 95% CI - 14.31 to - 0.22) and a significant fourfold reduction in unmet care needs (intermediate outcome) (95% CI 0.06-0.94) compared to women in the care-as-usual group. No differences were found for quality of life (primary outcome), re-abuse, symptoms of depression, psychological distress, self-esteem (secondary outcomes), family support, and social support (intermediate outcomes). CONCLUSIONS: This study shows that CTI is effective in a population of abused women in terms of a reduction of post-traumatic stress symptoms and unmet care needs. Because follow-up ended after the prescribed intervention period, further research is needed to determine the full long-term effects of CTI in this population.
Asunto(s)
Mujeres Maltratadas/psicología , Personas con Mala Vivienda/psicología , Vida Independiente/psicología , Calidad de Vida/psicología , Adulto , Mujeres Maltratadas/estadística & datos numéricos , Femenino , Personas con Mala Vivienda/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Países Bajos , Factores de TiempoRESUMEN
To help create an evidence base in Europe for effective interventions that improve the well-being of homeless people, we tested whether critical time intervention (CTI), a time-limited intervention developed to support vulnerable people during times of transition, is effective outside the United States. For this multicenter, parallel-group randomized controlled trial, 183 adults who were moving from shelters in the Netherlands to supported or independent housing were allocated to CTI or care-as-usual. The primary outcome was number of days rehoused, which was assessed by interviewing participants four times during a 9-month follow-up. Outcomes were analyzed with three-level mixed-effects models. The primary outcome did not differ between groups. CTI had a significant effect on family support and, for people experiencing less social support, psychological distress. Groups did not differ significantly on social support, fulfillment of care needs, quality of life, self-esteem, excessive alcohol use, or cannabis use. Because few participants were homeless at 9 months, more research is needed to establish whether CTI can prevent long-term recurrent homelessness. Given recent emphasis on informal support in public services and positive effects of CTI on family support and psychological distress, CTI is a fitting intervention for Dutch shelter services.
Asunto(s)
Vivienda , Personas con Mala Vivienda/estadística & datos numéricos , Vida Independiente , Calidad de Vida , Apoyo Social , Estrés Psicológico/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Femenino , Personas con Mala Vivienda/psicología , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Autoimagen , Estrés Psicológico/psicología , Factores de TiempoRESUMEN
BACKGROUND: Due to intimate partner violence (IPV), a proportion of some women seek safety from their abuser in shelters. Little is known yet about whether the received shelter interventions, offered during and after women's stay, are effective. Therefore, a meta-analysis of studies was performed, testing the effectiveness of interventions administered to female IPV victims during and/or after their residence in shelters, in terms of mental health, re-abuse and social outcomes. METHODS: From January 1985 through July 2011, five databases were searched for English-language articles. Original research articles evaluating the effects of interventions provided to IPV victims during and after shelter residence were identified. Hedges' g effect sizes and 95% confidence intervals (CIs) were calculated and pooled if three or more studies including one outcome type were available. RESULTS: Ten original studies, including a total number of 726 female IPV victims, were analysed. We found that shelter interventions were effective in improving mental health outcomes (g = -0.39; 95% CI: 0.24-0.54), in decreasing abuse (g = 0.32; 95% CI: 0.08-0.55) and in improving social outcomes (g = 0.71; 95% CI: 0.54-0.88) in shelter-based abused women. CONCLUSION: This analysis suggests that interventions provided during and after stay in a shelter are effective in improving mental health, abuse and social outcomes, but further research has to confirm this. Moreover, future studies should compare different type of interventions and should evaluate cost-effectiveness.
Asunto(s)
Terapia Cognitivo-Conductual/estadística & datos numéricos , Vivienda , Trastornos Mentales/terapia , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Maltrato Conyugal/psicología , Adulto , Femenino , Humanos , Apoyo Social , Maltrato Conyugal/prevención & control , Estrés Psicológico/terapia , Estados UnidosRESUMEN
We conducted a concept mapping exercise to gain insight into the perspectives held by abused women and professionals with regard to appropriate care in Dutch women's shelters. Three brainstorming sessions generated 92 statements that were then rated by 56 clients and 51 professionals. A total of 11 clusters were identified. The three most important clusters were "help with finding a safe house if necessary," "safety and suitable care for the children," and "a personalized, respectful approach." The most important statement was "take women seriously and treat them with respect." The mapping exercise identified key practice-based elements of intervention that should better accommodate the needs of shelter-based abused women. We have used these elements in developing a new intervention for shelter-based abused women in the Netherlands.