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