Fidelity of a Strengths-based method for Homeless Youth Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen”
Manon krabbenborg, Sandra Boersma, Marielle Beijersbergen & Judith Wolf
[email protected]
Onderzoekscentrum maatschappelijke zorg
Homeless youth in the Netherlands
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Latest estimate: 9000 homeless youths
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Economic recession: reduction in (supervised) jobs and subsidized housing
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Lack of evidence-based interventions/methods
Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen”
Onderzoekscentrum maatschappelijke zorg
Houvast: A Strengths-based intervention for homeless youth •
Houvast = Dutch for ‘grip’
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Developed by Judith Wolf, derived from Strengths-based Model
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Aimed at improving quality of life
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Onderzoekscentrum maatschappelijke zorg Focus on strengths and capacity for autonomy and self-reliance
“gedreven door kennis, bewogen door mensen”
Onderzoekscentrum maatschappelijke zorg
Houvast: A Strengths-based intervention for homeless youth •
Focus determination: 6 weeks -> trusting working relationship -> strengths assessment
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Supporting the the personal recovery process: 3 months -> goal setting Onderzoekscentrum maatschappelijke zorg -> action/recovery plan “gedreven door kennis, bewogen door mensen” -> using available resources
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Completion and evaluation: 6 weeks -> strengthening of social and professional networks
Onderzoekscentrum maatschappelijke zorg
Testing the effectiveness and fidelity of Houvast •
Multi-site quasi experimental study
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Funded by The Netherlands Organization for Health Research and development (ZonMw)
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Dutch services for homeless youth: 5 experimental sites Onderzoekscentrum maatschappelijke zorg 5 control sites
“gedreven door kennis, bewogen door mensen”
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251 youths interviewed at baseline (T0), 6 months (T1) and 9 months (T3)
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Measurement of QoL, mental & physical health, substance use, coping, resilience, working relationship, personal goals and care needs
Onderzoekscentrum maatschappelijke zorg
Implementation activities of Houvast •
4-day training for all professionals and two follow-up training days
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2,5-day training for team leaders or supervisors
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6-day training for internal coaches
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Meeting for directors
Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen”
Onderzoekscentrum maatschappelijke zorg
Testing the fidelity of Houvast •
Fidelity assessment around T1 (6 months after implementation)
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Service accommodations trained in the strengths-based method (n = 5)
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Questionnaire for professionals 2 weeks prior to audit
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Onderzoekscentrum maatschappelijke zorg One-day audit by trained researchers: “gedreven door kennis, bewogen door mensen” -> observation of a strengths based group supervision -> file analysis (n = 12) -> focus discussion with youths -> interviews with team leader and supervisor
Onderzoekscentrum maatschappelijke zorg
Strengths model fidelity scale (Rapp & Goscha,2011) •
Structure:
1) professionals’ responsibilities 2) caseload ratios
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Supervision:
3) supervisor 4) group supervision
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Clinical practice:
Onderzoekscentrum maatschappelijke zorg 5) strengths assessment “gedreven door kennis, bewogen door mensen” 6) integration of strengths assessment 7) personal recovery plan 8) community contact 9) use of available resources 10) hope-inducing behavior
Onderzoekscentrum maatschappelijke zorg
Implications for implementation – organizational level
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Facilitation by management
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Start slow – establish one high fidelity site and build from there.
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Infrastructure should support Strengths Model implementation
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Onderzoekscentrum maatschappelijke zorg door kennis, bewogen mensen” Regular fidelity assessments and“gedreven dissemination of results at alldoor levels
Onderzoekscentrum maatschappelijke zorg
Implications for implementation – individual worker •
Shifting from a problem-oriented approach to a strengths-based approach takes time
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Coaching on the job and quality supervisors at the team level are crucial
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Focus on skill development Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen”
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Booster sessions
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Evaluation in terms of fidelity and outcomes
Onderzoekscentrum maatschappelijke zorg
Thank you!
Onderzoekscentrum maatschappelijke zorg “gedreven door kennis, bewogen door mensen”
