Evaluation of outpatient treatment units according to the Crime Victims' Regulation Act

• Published in: Zeitschrift für Psychosomatische Medizin und Psychotherapie 2012, Vol.58 (1), p.42-54
• Main Authors: Bollmann, Kirsten, Schürmann, Ivonne, Nolting, Björn, Dieffenbach, Ina, Fischer, Gottfried, Zurek, Gisela, Bering, Robert, Heuft, Gereon
• Format: Article
• Language: ger
• Subjects: Adolescent; Adult; Ambulatory Care Facilities - legislation & jurisprudence; Child; Crime Victims - legislation & jurisprudence; Crime Victims - psychology; Crisis Intervention - legislation & jurisprudence; Female; Follow-Up Studies; Germany; Humans; Male; Outcome Assessment (Health Care); Personality Inventory; Referral and Consultation - legislation & jurisprudence; Sex Offenses - legislation & jurisprudence; Sex Offenses - psychology; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - therapy; Wounds and Injuries - psychology; Young Adult
• ISSN: 1438-3608
• DOI: 10.13109/zptm.2012.58.1.42

Over the past years, 35 trauma outpatient units have been established in accordance with the Crime Victims' Compensation Act in the federal state of North Rhine-Westphalia (Germany) for both children and adolescents as well as for adults. They are operated by the social welfare authorities and, since 2008, by the regional authorities of Westphalia-Lippe and Rhineland. They enable victims to receive qualified psychotraumatological help within the first few days after suffering violence. Since trauma units have now been set up across most parts of this federal state, the time has come to assess the effectiveness of their acute care provision to victims of violence. In 2007, on the order of the Ministry of Labour, Health and Social Affairs of the federal state of North Rhine-Westphalia, trauma outpatient units were subjected to scientific evaluation. In 17 trauma outpatient units, a data assessment protocol was officially implemented that included repeat measurements (immediately before the initial contact, after completion of intervention, at follow-up six months after intervention) of traumatized subjects aged 14 and older. Socio-demographic data were gathered, and the scores of the Impact of Event Scale - Revised (IES-R), the Symptom Checkliste-27 (SCL-27), the simplified Beck Depressions Inventory (BDI-V), the Global Assessment of Functioning Scale (GAF) as well as the Cologne Risk Index (CRI) (expert rating) were collected. Nearly three-fourths (65.9 %) of the traumatic experiences of the 211 patients investigated can be characterized as type-1 traumatisation. 31.8 % of patients were victims of crimes involving violations of the right to sexual self-determination (94.0 % of sexual offences being committed against girls and women). Crimes against physical integrity, which according to crime statistics are the most frequent of crimes against individuals (88.8 %, 34.8 % females), were suffered by 36.0 % of all patients of the trauma outpatient units (63.2 % being females). In 57.1 % of the victims, the interval between the traumatic event and initial intervention was less than a month. In 51.7 % (n = 109), suspicion of PTBS (F43.1) was raised at the initial presentation. The average of all instruments yielded an effect size of d = 1.04 (SD = 0.28) in a pre-post comparison. Pair-wise comparison showed highly significant differences in averages between pre and post (that is, between initial and follow-up measurements) in the sense of marked symptom reduction