Initial Effectiveness Evaluation of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Homeless Women.

The purpose of this study is to evaluate the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders adapted for homeless women (UPHW). Eighty-one homeless women participated in this single-blinded quasi-experimental clinical trial, involving up to 12 sessions of group treatment, and 3-and 6-month follow-ups. The participants received either immediate treatment with the UPHW (n = 46) or delayed treatment, following a 12-week wait-list control period (WLC; n = 35). Primary outcomes included depression and anxiety. Secondary measures comprised positive and negative affect, psychological well-being, health perception, and social support. The UPHW resulted in significant improvement on measures of anxiety, depression and negative affect. Improvements in anxiety and depression were maintained over a 3-month follow-up period, but not at 6-month. The reliability of the clinical changes showed significant differences between UPHW and WLC for depression. Moreover, the inter-session assessment in the UPHW group showed a linear trend reduction for depression and anxiety scores along the 12 sessions. The clinical implications on the UPHW in social settings are also discussed.

Application of the unified protocol for transdiagnostic treatment of emotional disorders among homeless women: A feasibility study.

Despite the high prevalence of emotional disorders and comorbidity among homeless women, there is a shortage of studies focused on interventions targeted at this population. This study aims to examine the feasibility of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders among homeless women, in relation to its quantitative effects on attendance, satisfaction, usefulness, emotional state, and group cohesion. The trial was registered at clinicalstrials.gov as NCT04392856. We use a one-group pretest-posttest design. The program consisted of 12 group sessions of approximately 90 min each. Treatment was provided to 54 homeless women, who were recruited from four different shelters in Madrid (Spain). The average attendance rate was 69.44%. Participants reported high levels of satisfaction (M = 8.97, SD = 1.45; out of 10), perceived usefulness (M = 9.10, SD = 1.42; out of 10), mood state (M = 6.11, SD = 1.02; out of 7), and group cohesion (M = 6.34, SD = 0.86; out of 7). There was a significant increase in the total score across these four variables following treatment. These findings suggest that the Unified Protocol is a feasible intervention for homeless women and may be beneficial; however, further studies that include a control group and a larger sample are on progress to test its effectiveness. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Role of Stressful Life Events among Women Experiencing Homelessness: An Intragroup Analysis.

The aim of this study is to examine stressful life events (SLEs) among homeless women and how SLEs were related to patterns and trajectories of homelessness. Specifically, the study aimed to replicate and build upon by Muñoz et al. (2005) by using cluster and discriminant analysis in a sample of 116 homeless women. The sample was classified based on SLEs, and the relationship between the resulting subgroups and sociodemographic characteristics, homeless trajectories, physical and mental health, and social support was examined. The results suggest that the three-cluster solution was theoretically and structurally meaningful: (a) the "Shorter homelessness trajectories and best health and mental health" subgroup was characterized by low levels of SLEs, a shorter homeless trajectory, lower prevalence of physical and mental health problems, and lower rates of alcohol and substances consumption; (b) the "Early onset of homelessness and poorer health and poorer mental health" subgroup was characterized by a higher prevalence of childhood and adolescence SLEs, an early onset of homelessness and greater chronification, mental health problems, and alcohol consumption; and (c) the "Chronic homelessness and poorest health and mental health" subgroup was mainly characterized by a higher prevalence of typically adulthood SLEs, as well as some SLEs that may be unique to women, a greater number of periods of homelessness, physical health problems, disabilities, and substance misuse. Increased knowledge about the different subgroups and trajectories of homeless women, as well as their specific characteristics and needs, will help us design social services and policies sensitive to all these differences.

Differences in stressful life events between men and women experiencing homelessness.

People experiencing homelessness are particularly vulnerable to experiencing stressful life events (SLEs) at some point in their lives; these SLEs are crucial for understanding the etiology and maintenance of homelessness. This study analyses the differences between men and women experiencing homelessness in the suffering of SLEs throughout their lives (childhood, adolescence, and adulthood). The sample consisted of a group of 293 people experiencing homelessness in Madrid (Spain): 156 men and 137 women. The results suggest that the number and type of SLEs experienced by men and women are different. In general, women experiencing homelessness suffer more SLEs than men in all periods of their lives. The differences in the level of sexual violence in childhood, sexual abuse in adulthood, and abuse by a spouse or partner are particularly striking. However, men experiencing homelessness score significantly higher than women for alcohol abuse, police complaints, arrest, and imprisonment throughout their lives. These findings have significant implications for the design of interventions and social policies that should be tailored to the specific needs of men and women who are homeless.

Risk of mental ill-health among homeless women in Madrid (Spain).

Several studies have revealed that homeless people suffering from mental health problems are more vulnerable than homeless without those mental health problems. Nevertheless, there is a lack of evidence describing the real circumstances of homeless women. This paper explores the differences between homeless women at high risk of mental ill-health compared with those who do not present this risk. The sample consisted of a group of 120 homeless women in Madrid (Spain). For this study, we collected data on background information (trajectory of homelessness and stressful life events experienced) and current aspects (living conditions, physical health, and social support). The risk of mental ill-health has been measured by the short version of the General Health Questionnaire (GHQ-28). The results showed that homeless women with higher risk of mental ill-health had become homeless at a younger age, had experienced more stressful life events in their lives, had a poorer physical health, felt less happy, had less social support, and a greater feeling of loneliness when compared with homeless women who did not present risk of mental ill-health. Improving knowledge about the risk of mental ill-health among homeless women is essential for the design of specific psychological interventions within this population.

"Puerta giratoria" a la situación sin hogar. Influencia de la salud, consumo de alcohol y padecimiento de sucesos vitales estresantes en el número de episodios en la situación sin hogar / The revolving door to homelessness. The influence of health, alcohol consumption and stressful life events on the number of episodes of homelessness

Objetivos: Analizar la incidencia de diferentes variables en el padecimiento de reiterados episodios en la situación sin hogar. Método: El trabajo se realizó a partir de los datos obtenidos de una muestra representativa de las personas en situación sin hogar en Madrid (España) (n=188). Resultados: El padecimiento de una enfermedad grave o crónica ejerce un efecto en la "puerta giratoria" a la situación sin hogar mediado por una percepción subjetiva muy negativa de la propia salud que, a su vez, se encuentra mediada por el padecimiento de alguna discapacidad. El consumo excesivo de alcohol ejerce un efecto en la "puerta giratoria" a la situación sin hogar mediado por el acceso a tratamiento por problemas derivados de dicho consumo. Padecer una enfermedad grave o crónica correlaciona con tener o haber tenido problemas derivados de un consumo excesivo de alcohol. El padecimiento de múltiples sucesos vitales estresantes ejerce un efecto directo en la "puerta giratoria" a la situación sin hogar. Conclusiones: Para prevenir la "puerta giratoria" a la situación sin hogar hay que eliminar las barreras que dificultan el acceso a los recursos normalizados de salud a las personas en exclusión social, a la vez que implementar programas continuados de apoyo para las personas sin hogar o en riesgo que incluyan prioritariamente cuestiones de salud

Objectives: To analyse the impact of different variables on repeated episodes of homelessness. Method: The study was conducted based on data obtained from a representative sample of homeless people in Madrid (Spain) (n=188). Results: Suffering from a serious or chronic illness has an effect on the revolving door to homelessness, which is mediated by a highly negative subjective perception of the individual's own health, which is in turn mediated by suffering from a disability. Excessive alcohol consumption has an effect on the revolving door to homelessness, mediated by access to treatment for problems caused by alcohol consumption. Suffering from a serious or chronic illness correlates with having problems caused by excessive alcohol consumption. Experiencing multiple stressful life events has a direct effect on the revolving door to homelessness. Conclusions: To prevent the revolving door to homelessness, it is necessary to remove the barriers that hinder access to normal health resources which are experienced by people suffering from social exclusion, while implementing on going support programmes for homeless people or those at risk of homelessness, which primarily deal with health issues