Homelessness and Domestic Violence

1
Homelessness and Domestic Violence

• Adapting Dialectical Behaviour Therapy to the
  needs of women who have experienced domestic
  violence
• Dr Suzanne Sambrook
• Consultant Clinical Psychologist

2
Pilot project between Southampton Womens Aid and
Hampshire Partnership Trust

• Funded by the Homelessness Directorate
• And
• Southampton City Housing Department

3
Link between domestic violence and homelessness

• Temporary homelessness
• Staying in refuge, bed breakfast, friends
• Cycles of homelessness
• Repeated attempts to leave abusive situations
• Difficulties in maintaining tenancy

4
Effects of Domestic Violence

• Decreases in self confidence
• Decreased self-esteem
• Decreased ability to cope with demands of day to
  day life
• Anxiety
• Depression
• Post traumatic stress disorder
• Physical ill health

5
Cycle of repeat homelessness
leave home temp accommodation return
home fear of not coping disruption lack of
skills Guilt
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The project

• Aim to break the cycle of repeated homelessness
  by
• Increasing ability to take control of life
• Improving self-esteem
• Prevent cycles of self-defeating behaviour
• Improve ability to live independently

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Therapeutic approach

• Dialectical Behaviour Therapy
• Designed to help people who get trapped in
  repeated cycles of self-defeating behaviour
• Focuses on enhancing capabilities
• Teaches skills to manage life effectively

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What makes DBT different?

• Focus on dialectics
• Balancing opposites, finding the middle ground
• Combines traditional approaches with ideas from
  Zen traditions
• Mindfulness
• Acceptance

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Mindfulness

• Mindfulness means paying attention in a
  particular way
• On purpose
• In the present moment
• Non-judgementally

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The project

• Phase 1
• Using group format for therapy
• Supporting staff by providing two workshops about
  the therapy

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The group

• 12 x 2 hour sessions (including pre-group
  meeting)
• Topics
• Mindfulness
• Understanding emotions
• Distress Tolerance
• Problem Solving
• Assertiveness

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Problems identified by the group members

• Lack of confidence
• Difficulties expressing self
• Feelings of guilt and failure
• Difficulties making decisions
• Worries about parenting

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Evaluation

• Measures
• Well being
• Symptoms of anxiety depression
• Coping
• Self-esteem
• Control

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Results 1
15
Results 2
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Individual ratings over time
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Feedback from participants

• All positive
• Improved ability to manage emotions
• Therefore able to think more clearly
• Improved ability to solve problems
• Managing interactions with others more
  successfully
• More in control of their lives

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Difficulties

• Regular attendance
• Childcare
• Sustainability

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Phase two

• Training staff at Womens Aid
• Co-facilitating groups with the staff
• Supporting staff in their work with the women

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Training staff

• Experiential group
• Similar format but shorter
• Evaluated in the same way

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Results 1
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Staff group progress on individual goals
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Co-facilitation of groups and staff support

• Two groups run
• Hurdles
• Time
• Confidence
• Knowledge

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Overall Outcomes

• Strengths
• Productive collaboration
• Empowering both the workers at Womens Aid and
  the women attending
• Anecdotal evidence of positive effects on tenancy

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Problems

• Time
• Long term follow up
• Fitting together two very disparate services
• Reactivity of the setting
• Sustainability

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Conclusions

• Rigidity of Health Service makes it more
  difficult to work in the way that is needed.
• BUT
• DBT is a useful approach and can be adapted in a
  very positive way
• Positive inter-agency working is achievable
• Future working must be focused on sustainability