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The effectiveness of critical time intervention for abused women leaving women's shelters: a randomized controlled trial

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.

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The effectiveness of critical time intervention for abused women leaving women's shelters: a randomized controlled trial

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Participatie van ouderen binnen een woonservicegebied. Hoe ervaren ouderen, woonachtig in woonservicegebied de Zeevang, hun mogelijkheden tot participatie ?

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Understanding how engagement in a self-managed shelter contributes to empowerment

Participant empowerment is a foundational goal of selforganisedhomeless care. We aim to understand how a selforganisedsetting contributes to participants' empowerment.The data we analysed (56 interviews, both open and semistructured)were generated in a longitudinal participatorycase study into Je Eigen Stek (Your own place, JES), a lowcostshelter for people experiencing homelessness in theNetherlands. JES participants experienced the freedom ofchoice and influence on their living environment. JES' fluidstructure allowed participants to adapt the program to theirdesires and needs, though participants were sometimes aspects to be either enabling or entrapping. We found someaspects (e.g., size, freedom of choice) could be entrapping orenabling, depending on personal factors. Our analysis revealedindividual freedom of choice, balancing freedom of choicewith support, offering opportunities for engagement andmaintaining fluidity in program management as core aspectsof how JES contributed to participants' empowerment.negative about having to live together. Most participantspreferred JES over regular shelters. Unlike empowermentliterature, participants mostly emphasised freedom of choiceover capacity development. JES offered opportunities forsocial and organisational engagement, through which participantsdeveloped roles, skills and self-image. However, alimited number of participants developed leadership rolesthrough self-management. Literature suggests setting

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Understanding how engagement in a self-managed shelter contributes to empowerment

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Weaving the Feral – Cabinet of Feral Data Curiosities: Living - with Feral Ecologies festival

The installation presents our ongoing investigation of feral ways of knowing, being, and living-with diverse more-than-human ecologies. On display are feral data artifacts such as woven sashes, multispecies tattoos, short dérive films, and an eel trap, all which speak of environmental knowledge and cosmologies in various more-than-human habitats including Colombian chagras, Bohemian forest, Croatian wetlands, and the Gunditjmara Country. Participants are invited to spend time with the artifacts and delve into the stories – of feral relationships and care as well as power and structural inequalities – that they weave together.

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Improving continuity of forensic mental health care

Purpose – Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue. Design/methodology/approach – The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted. Findings – The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education. Practical implications – Gathering best practices about regional collaboration networks and developing a blue print based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental healthcare. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories,even if there are Setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed. Originality/value – Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

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A sense of home through the eyes of nursing home residents

The nursing home is often a final stage in the living career of older persons, but the question remains whether it is a true home or merely a place where care is provided for the residents. This study investigates the sense of home and its constituent factors among both permanent and temporary residents of nursing homes in The Netherlands. A qualitative research design was chosen for the study, which consisted of in-depth interviews using a topic list that was developed through literature review and a focus group session. Autonomy and safety and security are the basic aspects for a sense of home. These aspects refer to the relationships and actions of nursing home residents and the environment in which people live. The research findings show that developing a sense of home encompasses much more than just being surrounded by personal belongings and having a private room with certain facilities. Subjective components of relationships and (inter)actions are as important as the physical component of living and housing. Only when a right balance is achieved between all factors, a true sense of home, albeit away from the familiar home someone spent most of his/her life, can be developed. Understanding these perspectives and needs can contribute to a better design and retrofitting process of future nursing homes.

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A sense of home through the eyes of nursing home residents

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Towards Responsible Rebellion

In the Netherlands, there is an increasing need for collective forms of housing for older people. Such housing bridges the gap between the extremes of living in an institutionalised setting and remaining in their own house. The demand is related to the closure of many residential care homes and the need for social engagement with other residents. This study focuses on housing initiatives that offer innovative and alternative forms of independent living, which deviate from mainstream housing arrangements. It draws on recent literature on healthcare ‘rebels’ and further develops the concept of ‘rebellion’ in the context of housing. The main research question is how founders dealt with challenges of establishing and governing ‘rebellious’ innovative living arrangements for older people in the highly regulated context of housing and care in the Netherlands. Qualitative in-depth interviews with 17 founders (social entrepreneurs, directors and supervisory board members) were conducted. Founders encountered various obstacles that are often related to governmental and sectoral rules and regulations. Their stories demonstrate the opportunities and constraints of innovative entrepreneurship at the intersection of housing and care. The study concludes with the notion of ‘responsible rebellion’ and practical lessons about dealing with rules and regulations and creating supportive contexts. Original article at MDPI; DOI: https://doi.org/10.3390/ijerph17176235 And atachment "Supplementary Materials" (This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives")

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Towards understanding what Dutch people in a socio-economically disadvantaged position need to enhance their living conditions

This thesis has increased our knowledge of the needs of homeless people using shelter facilities in the Netherlands and of the needs and wishes of people living in persistent poverty. It provides guidance for policy and further professionalization and quality improvements to the services and support provided to homeless people and people living in persistent poverty. The results underscore the importance of broad and integrated policy measures to strengthen socioeconomic security, and emphasize the need for including the views of clients and experts by experience in the development of policy. Our research also stresses the need for services to employ peer workers to support homeless people and people living in persistent poverty and to apply a more human-to-human approach.

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Outcomes of living in a self managed shelter

Introduction and methodology In self-managed residential homeless care, consumers, and their peers, are in charge. Former consumers (N=24) of a self-managed homeless shelter were interviewed with qualitative structured topic-lists on the benefits they experienced. Former consumers of the program participated as co-researchers, together with students and experienced researchers. This research is part of a larger program researching self-managed residential programs. ResultsIn the self-managed shelter consumers can work on their recovery towards independent living. For the respondents, the self-managed shelter is a place where they can stay for a longer period without the stress of having to look for another place and without the hassle from social workers telling them what to do and how to behave. How the former consumers used this stability and freedom differs. Some worked towards independent living on their own, others also developed skills, self-worth and new social roles (helper, friend) through participation and others used the shelter to stay free from stress and hassle. Moving on towards independent living isn’t an immediate goal for the latter, although many consumers in the end started working towards independent living.Most of the respondents state that their live has improved when it comes to mental health, living situations and social aspects, although some respondents report issues with finances and social contacts. DiscussionThere are two main limitations to our research. Firstly, consumers who only stayed for a short while, consumers who stayed in the shelter more than a few years ago and consumer who left the program are underrepresented in our data. Secondly, a lot of the respondents deflected questions about their personal recovery (self-worth, trust, self-efficacy), because this ‘was not relevant for them’. Anecdotal evidence from peer workers and social workers and some of the respondents suggests that staying in the self-managed shelter contributes to personal recovery of consumers as well, but more research is necessary to determine how and to what extend consumers work on their personal recovery within self-managed programs.

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Producten 234

The effectiveness of critical time intervention for abused women leaving women's shelters: a randomized controlled trial

Participatie van ouderen binnen een woonservicegebied. Hoe ervaren ouderen, woonachtig in woonservicegebied de Zeevang, hun mogelijkheden tot participatie ?

Understanding how engagement in a self-managed shelter contributes to empowerment

Weaving the Feral – Cabinet of Feral Data Curiosities: Living - with Feral Ecologies festival

Improving continuity of forensic mental health care

A sense of home through the eyes of nursing home residents

Towards Responsible Rebellion

Towards understanding what Dutch people in a socio-economically disadvantaged position need to enhance their living conditions

Outcomes of living in a self managed shelter

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The effectiveness of critical time intervention for abused women leaving women's shelters: a randomized controlled trial

Participatie van ouderen binnen een woonservicegebied. Hoe ervaren ouderen, woonachtig in woonservicegebied de Zeevang, hun mogelijkheden tot participatie ?

Understanding how engagement in a self-managed shelter contributes to empowerment

Weaving the Feral – Cabinet of Feral Data Curiosities: Living - with Feral Ecologies festival

Improving continuity of forensic mental health care

A sense of home through the eyes of nursing home residents

Towards Responsible Rebellion

Towards understanding what Dutch people in a socio-economically disadvantaged position need to enhance their living conditions

Outcomes of living in a self managed shelter