Daphne project: 2003-108
Daphne Programme – Year 2003
Final Report
Project Nr.: JAI/DAP/03/108/W
Title:
JoinTheNet / HelpTheHelper II
Pan-European training courses on symptoms of violence: an impact appraisal
Start Date: 01.02.2004 End Date: 31.01.2005
Co-ordinating Organisation’s name: Therapeutische Frauenberatung e.V.
Contact person: Ilse Hilliger
Name:
Address: Groner Straße 32/33
Postal code: 37073
City: Göttingen
Country: Germany
Tel. No.: +49 (0551) 4 56 15
Fax Nr.: +49 (05519 531 62 11
e-mail:
Partner organisations’ names and countries:
Turku Centre for Women, Uudenmaankatu 1, 20500 Turku, Finland,
+358 (2) – 2 51 79 96,
BIFF – Beratung and Information für Frauen,
Ass. Solidarites, 259 bis, av. Pierre Sémard, 84200 Carpentras, France,
+33 (0) 4 90 60 36 84,
Ass. Telefono Amico, C.so Unione Sovietica 214/A, 10134 Turino, Italy
+39 (0)11 – 3 18 65 53,
Ass. Artemisia, Via del Mezzata 1/interno, 50135 Firenze, Italy,
+39 (0)55 – 60 23 11,
Komop “Plato”, 7th km National Road Antirrion, 30300 Nafpaktos, Greece,
+30 (26340) – 210 80
1. Project aim
Violence against women and girls can result in profound traumatisation. Traumas that are not dealt withlead to severe disorders, often without there being any physical basis for the condition. The prevalence of post-traumatic stress disorder (PTSD) is highest among the victims of sexual violence (almost all of whom are women and girls).There are many symptoms of complex PTSDs, of whichfear, depression, addiction, eating disorders, identityand personality disordersare only a few.
Aprevalence studyentitled “Lebenssituation, Sicherheit and Gesundheit von Frauen in Deutschland” (“Women in Germany: their life situation, safety and health”) was published by the Federal Ministry for the Family, Senior Citizens, Women and Youth during the year in which the project was implemented (in September 2004). The results confirm – indeed, they actually exceed - earlier estimates; one in every two or three women in Germany has experienced physical violence, while every seventh woman has been the victim of sexual abuse by known or unknown persons since her 15th birthday. We must assume that pan-European figures are similar (see the chapter on “The prevalence of violence: a panEuropean comparison”). The international exchange of experience and information under the HelpTheHelper Project revealed the inadequacy of existing knowledgeabout the health impact of sexspecific violence, irrespective of national borders and in all the occupational groups concerned. This is why it is so important to disseminate the available material throughout Europe.
JoinTheNet seeks to raise awareness of violence-related disorders and the backgroundto them among social, medical and public service professionals (the target group). The aim is to enable the target group to identify relevant symptoms presented by their women clients and to provide competent advice to victims of violence. Efficacy and sustainability are also intensively evaluated.
The project’s beneficiaries are women and girls who have developed health disorders or symptoms relating to complex PTSDs. If information deficits and uncertainty about the correct action to take among the target group can be reduced, the beneficiaries' chances of receiving proper assistance will be booked.
The project objective was to be attained through specialised training for the target group.
This special training is based on training materials (audiovisual materials and an overall educational philosophy) which were developed under the auspices of the previous project (HelpTheHelper) by the coordinator, together with British and Spanish partners, and subjected to a pre-test. These triedandtested materials were to be disseminated in another four EU Member States.
A total of between 70 and 100 training sessions in five countries were planned (France, Greece, Finland, 2 x Italy, 2 x Germany). Comprehensive databases listing institutions and facilities in the partner countriesthat provide specialised support to people suffering from sexual abuse and PTSD (counselling centres, psychotherapy practices and clinics) were to improve the quality of counselling. The idea of the accompanying public relations campaign was to raise awareness of the issue amongpublic bodies, particularly those with a particular professional involvement, and persons with political responsibility, by informing them about the manifestation of symptoms and the sex-specific nature of the phenomenon. The purpose of the in-depth evaluation to be conducted by a professional from outside the project was to investigate the efficacy and sustainability of the training courses.
The most importance outcome is the dissemination of tried–andtested materials in four more EU Member States. The beneficiaries will benefit from improvements in the operation of the social and health services and increased awareness at political level.
2. Implementation
The Commission’s permission was requested to postpone the start of the project by a month, as the preceding project, HelpTheHelper, had to be wound up first.
Overall, the implementing parties complied with the established time-frame.
2.1. Activities
2.1.1. 1st stage of the project: February and March 2004
Setting up an internal steering group
Contacting partners
Adapting training materials
Establishing tools for evaluation
Setting up regional databases of institutions providing assistance
Selection of the 10-15 institutions to receive training
At the outset of the project, the staff of Therapeutische Frauenberatung e.V.(“Counselling for Women”) set up an internal steering group charged with conducting ongoing checks on project planning and implementation. The steering group was to be informed about the project’s state of progress at two to three-weekly intervals. It was also to be notified of any outstanding tasks, and substantive issues were to be discussed.
The project coordinators, Wiebke Landwehr and Bettina Schneider, quickly contacted our partners and informed them about the exact timetable and the tasks allocated. Discussing and resolving specific issues relating to particular tasks by e-mail and telephone was a straightforward matter. Initial press work began.
We assessed the training material produced by the HelpTheHelper Project to ascertain whether it was appropriate for the new project partners. It was clear that there was no need for radical revision or alterations.
All the training materials already produced (film and print materials, underlying philosophy) are based on an open design, taking the form of a modular system to which further modules can be added. This means that content can be selected precisely as required and presented in the way appropriate to the particular target group. This structure also proved, on numerous occasions, to be particularly well suited to adapting the material in line with individual countries’ particular needs.
The six modules cover the following themes:
* What is trauma? (definition)
* How do I recognise a post-traumatic stress disorder? (symptoms)
* Who are the people affected? (risk factors and prevalence)
* What happens in the brain? (reactions affecting the physiology of the brain)
* What can therapy - particularly trauma therapy procedures – do to help?
* Who can help? What helps? (advice/counselling and referral).
We drew on the experience of HelpTheHelper as regards the technical aspects of adapting the material. The fact that the film was available both as a DVD and on video had proved to be invaluable, given the different technical conditions and viewing habits of the various European partners. The DVD enables optimum use to be made of the film’s modular structure, as individual chapters can be selected as required. We therefore recommended our partners to opt for the DVD in preference to the video wherever possible. We informed our new partners of the experiences of our British and Spanish partners from the HelpTheHelper Project as regards technical difficulties during training sessions and tried–andtested ways of resolving such problems.
As the training plan developed by HelpTheHelper is made up of modules, each partner can adapt it in line with local conditions. It was therefore possible to use it unaltered.
The alternation of information and empathy is one of the training plan’s most valuable features. Training begins with an exercise designed to encourage participants to put themselves in the place of person with post-traumatic stress symptoms. This is because simply observing traumatised people from the outside is often not enough to enable helpers to understand their frequently contradictory behaviour. Practical information alternates with action-oriented phases. For example, participants can practise a counselling session through role-play so as to develop confidence in their own competence. We kept the plan open, it being up to the various partners in Greece, France, Germany, Italy and Finlandto adapt it to their own country’s specific circumstances and their own capacity.
A firm called Compact translated all the printed material (the training plan and the materials for trainers and participants / CD-ROM), as well as the text accompanying the film, into three more languages (French, Italianand Greek). Neueform, the firm which had originally produced the film, also produced the Greek, French and Italian versions.
Initially our Finnish partner organisation was given an English-language version, produced under the HelptheHelper Project. We had assumed that the target group in Finland would have sufficient knowledge of English. However, this later proved to be a mistake (see 2.2., Unplanned activities).
In collaboration with Frauke Rodewald, the psychologist who evaluated HelpTheHelper, we developed two standard questionnaires for participants in the training sessions (the target group). The first questionnaire was intended to be completed immediately after training, while the purpose of the second questionnaire was to investigate what impact the knowledge acquired had had on actual practice two to three months after training (sustainability, see Chapter 3: The project’s results and impact).
At this stage, the partners’ job was to draw up a list of regional institutions providing assistance to women and girls who had suffered violence. These lists were to be ready by the start of the training phase at the latest, so that they could be made available for the participants’ use. We sent the partners a standard form for this purpose.
While some of the partner organisations already had such lists, which merely needed to be updated, others had to put more effort into researching and establishing such a database. However, all the partners regarded these databases as an important constituent element of the overall training. The Greek partner organisation was unable to list any institutions proving assistance: it stated that there were none in the region. In Germany we updated our existing data.
At the same time, both we and our partners began to recruit people interested in training courses. Our experience from the HelpTheHelper Project suggested that it was particularly important to make it clear to partners that they must actually focus on the planned target groups. Psychotherapists and analysts already working systematically with trauma victims are not a suitable target group for the training sessions.
This stage of the project went off smoothly, thanks to the information leaflet we had produced for all the countries concerned at the recruitment stage, public relations work with the press and good networking with other institutions. It was absolutely clear that the training on offer met a great need in the partner countries as well.
2.1.2. Project Phase 2: March/April 2004
Preparations for and implementation of the international workshop
held in Göttingen from 29March to 2April 2004
The experience we had gained through the HelpTheHelper Project impelled us to hold an international workshop as early as possible in the project.In the southern European countries, in particular, it is hard to recruit participants in training groups during the summer months. We aimed to initiate our partners in the implementation rules as early as possible, so that we could start on the specialised training in good time before the summer break, especially as southern Europe, where a long summer break is the norm, was strongly represented in this project, with partners from southern France, Greece andItaly (two). Greece was also to host the Summer Olympics during the project year.
“As early as possible” meant as soon as the training materials had been adapted.
Holding an international meeting at an early stage has other advantages, too: personal contact with partners makes subsequent communication a good deal easier. We started off by discussing the possible problems that might arise for individual partners as regards the organisation, methods or content of the training sessions and looked for possible solutions. Through intensive personal discussion of the overall plan, we were able to make changes reflecting the needs of particular countries.
When planning the workshops, we did our utmost to find a structure which would optimise communication between all the participants, irrespective of their country of origin. The training plan served as a basis. Although the language used in meetings was English, we made sure that the initial training materials were available in the languages of the countries concerned (Finland being the only exception; see below).
The workshop was held on our premises in Göttingen from 29March to 2April. There were intensive working sessions, with gripping discussions. Contacts outside the workshop sessions were very informative for everyone, too, and they took place in a friendly, cooperative atmosphere. Good, intensive contacts between the various partners concerned and effective cooperation made this meeting a special event for all those involved.
Unfortunately, there was no-one from one of the Italian partner organisations, Artemisia (from Florence), as its representative, Alessandra Pauncz, fell ill just before the workshop. Diana Rucli (of Telefono Amico,Turin) kindly offered to inform Artemisia about the course of events during the meeting, its results and the way in which the training sessions were to be run. Her kind and spontaneous assistance was invaluable for all parties concerned.
Running the workshop
We began by presenting the project as a whole and the previous project, HelpTheHelper, to our partners. We dealt with the results of the evaluation of HelpTheHelper in particular detail as they were of great interest to participants.
The partners then went on to provide information about their organisation, their working methods and the underlying theory (see section on the Role of the Partners below).
On the second day we focused on thesituation as regards care for women and girls who are victims of violence in the various countries concerned. This topic was based onthe following questions:
- Are there any national studies and/or statistics on violence against women and girls and the impact on their health?
- What sort of structure does the public health system in the countries have, and what implications does this have for women and girls who suffer violence?
- Where can the women and girls concerned find help, and how is it funded?
- How is psychotherapy funded?
- Is special therapy for trauma available?
The partners were also required to report on what stage they had reached with finding staff to participate in training sessions.
France
MarieClaude Geigant of Association Solidarités presented a recent survey on domestic violence commissioned by the Ministry for Women and conducted by a demographic institute. 10% of the 2000 women aged between 20 and 70 who were interviewed by telephone said they had experienced violence. Socially vulnerable women were particularly frequently affected.
MarieClaude Geigant reported that although France had a basic sickness insurance safety net, only officially registered persons were covered. Illegalimmigrants from north Africancountries, for instance, who represent a large group in southern France, were often not insured at all. Yet women belonging to this group were relatively frequently victims of violence. In individual cases it was possible to obtain “vouchers” for medical care from social agencies.
Nearly all towns had centres offering psychotherapy, but these provided only very short-term counselling and there were long waiting times. Private psychotherapy practices were the usual solution for women able to pay their way, and there was more chance of finding professionals qualified in trauma therapy at such practices.
Victims of violence sought help primarily from doctors and social workers.
Ms Geigant was planning to recruit participants for training courses from the following professional groups: social workers, police officers, staff from further education establishments andinstitutions providing protection for women, medical staff, regional women’s self-help groups and associations, and possibly doctors and lawyers as well. Doctors and police officers were a particularly important target group in France. The police had already clearly demonstrated their interest at this stage, but she was finding it difficult to recruit doctors. She often encountered negative attitudes, as the group concerned was not at all aware of any need for further training. A group of psychiatrists had already turned her down.
The training courses were to be held on the organisation’s own premises and at other institutions in Carpentras, Marseille and Avignon. Marie-Claude Geigant intended to lead the courses together with an assistant.