Implementation of a Resiliency Model of Care for Women Experiencing Homelessness

BACKGROUND: The majority of homeless women have experienced trauma. Trauma correlates with adverse mental and physical health outcomes. Resilience is a learned skill associated with better mental health and quality of life. Mindfulness-based interventions can increase resilience.

LOCAL PROBLEM: The project setting was an urban shelter serving homeless adults in East Tennessee. The population of interest was adult homeless women at the shelter. Shelter staff recognized the unique needs of women and sought to help women address trauma. Project aims were (a) implement the Community Resiliency Model (CRMÒ) as a mindfulness- and somatic-based approach to increase resiliency, (b) increase CRMÒ participation among women guests, and (c) 50% of participants will increase their resiliency by project completion.

METHODS: The Evidence-Based Practice Improvement (EBPI) model was the framework for project implementation. After conducting a systematic literature review, the CRMÒ was recommended to improve resiliency. The Patient-Reported Outcome Measurement Information System: Self Efficacy in Managing Emotions Short Form 8a (PROMIS 8a), and participant feedback measured effectiveness. Plan-Do-Study-Act cycles were used throughout the project.

INTERVENTIONS: Workshops were implemented teaching the six CRMÒ skills: tracking, resourcing, grounding, gesturing, Help Now, and Shift and Stay. CRMÒ helps individuals identify and re-enter their resilience zone if necessary. Eight workshops were held over a five-month period.

RESULTS: Average PROMIS 8a score increased over time, which was clinically significant but not statistically significant.

CONCLUSIONS: Two of three specific aims were met: (a) implement CRMÒ and (b) increase CRMÒparticipation. The third specific aim that 50% of participants would increase their resiliency score was not met. Based on the positive response and clinical significance the project site seeks to continue CRMÒ workshops and expand to other groups. Shelter staff will be trained in CRMÒ so workshops can continue.