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.
PurposeSelf-initiated expatriates (SIE) women's career decisions are often based on the establishment of close personal relationships in various spheres of life. This paper aims to explore the effects of social isolation in times of crisis on SIE women's work, psychological and general adjustment.Design/methodology/approachThe model of expatriate women's adjustment by Caligiuri and Lazarova (2002) is reviewed and adapted to account for the impact of social isolation and loneliness on SIE women's adjustment and professional development in a crisis context. The interplay between duration and intensity of crisis and acculturative stress over time is highlighted; danger zones for potential maladjustment are identified, and adjustment-as-a-crisis context are incorporated into the model.FindingsThe spillover effects between different life spaces in times of isolation have a negative impact on SIE women's ability to develop supportive relationships in different life spaces. The organization becomes the main point of contact with the host culture, but pressure to perform, uncertain contracts, gendered role division and the experience of a double crisis add to the existing acculturative stress which may lead to maladjustment or further fit-dependent crisis over time.Originality/valueThe authors contribute to the theoretical understanding of the impact of social isolation on a single, vulnerable acculturating group, by expanding on an existing static model of adjustment, to account for the temporal (time) and spatial (multi-dimensional crisis context) constraints faced by SIE women which has not been done before.
Objective To synthesise qualitative studies on women’s psychological experiences of physiological childbirth. Design Meta-synthesis. Methods Studies exploring women’s psychological experiences of physiological birth using qualitative methods were eligible. The research group searched the following databases: MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX and Psychology and Behavioural Sciences Collection. We contacted the key authors searched reference lists of the collected articles. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Results Eight studies involving 94 women were included. Three third order interpretations were identified: ‘maintaining self-confidence in early labour’, ‘withdrawing within as labour intensifies’ and ‘the uniqueness of the birth experience’. Using the first, second and third order interpretations, a line of argument developed that demonstrated ‘the empowering journey of giving birth’ encompassing the various emotions, thoughts and behaviours that women experience during birth. Conclusion Giving birth physiologically is an intense and transformative psychological experience that generates a sense of empowerment. The benefits of this process can be maximised through physical, emotional and social support for women, enhancing their belief in their ability to birth and not disturbing physiology unless it is necessary. Healthcare professionals need to take cognisance of the empowering effects of the psychological experience of physiological childbirth. Further research to validate the results from this study is necessary.
