Search

Background: In child and youth care, quantitative estimates of the impact of serious behaviour problems have not yet been made. Such input is needed to support decision making on investments in treatment. The aim of this paper was to elicit valuations of social and conduct disorders in children and adolescents from three different perspectives: professionals, youth, and parents., Methods: We obtained valuations from 25 youth care professionals, 50 children (age 9-10) without serious behaviour problems and 36 adolescents (age 16-17) with and without serious behaviour disorders, and 46 parents with children in the aforementioned age categories. Valuations were estimated from 18 descriptions of behaviour disorders in youth aged 9 and 15 years. Descriptions included Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Disruptive Behaviour Disorder (DBD). Comorbid conditions were Attention Deficit Hyperactivity Disorder and substance abuse. Valuations were obtained with the EuroQol questionnaire (EQ-5D-3 L) and a visual analogue scale (VAS)., Results: Valuations were generally severe; problems were by and large reported to worsen quality of life by 50% compared to being fully healthy. Professionals regarded DBD with substance abuse as most severe (VAS values 0.41 for children, and 0.43 for adolescents, i.e. less than half of normal). They rated ODD as least severe (VAS values 0.58 for children, 0.59 for adolescents). Children, adolescents and parents gave lower valuations than professionals, and had a wider range of scores, particularly at the lower end of the scale., Conclusions: Behaviour disorders pose a formidable burden from the perspectives of professionals as well as children, adolescents and parents. These results may support medical decision making to set priorities with regard to prevention and treatment based on perceived severity.

TAKECARE is a prospective cohort study designed in The Netherlands to obtain evidence on the care chain for children and adolescents with psychosocial problems, and its long-term outcomes. Little is known about the content of care as offered and on whether the care is adequate. The cohort consists of children and adolescents entering care for psychosocial problems (care sample, n = 1382) and a random sample of the general population (community sample, n = 666). Children were eligible for participation if they were aged 4-18 years (inclusive) and had estimated IQs of 70 and over. The care sample covers the fields of Preventive Child Healthcare (PCH), Child and Adolescent Social Care (CASC) and Child and Adolescent Mental Healthcare (CAMH). Children, parents or guardians and involved practitioners completed five questionnaires (baseline, and at 3, 12, 24 and 36 months thereafter). The main categories of data concern the sociodemographic characteristics of children and their parents or guardians, the characteristics of entry into care and care content, and intermediate and final treatment outcomes. Information about data access can be requested by e-mail: c4youth@umcg.nl., (© The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Expectations concerning barriers to children's psychosocial care seem to be major drivers when seeking help, but validated questionnaires measuring expectations are not available. Therefore, this study examined the psychometric properties of the parent and adolescent versions of the Barriers to Treatment Participation Scale-Expectancies (BTPS-exp), in terms of consistency, structure, parent-child agreement, and validity. The authors obtained data via questionnaires on 1,382 Dutch children aged 4-18 years (response rate 56.6%) enrolled in psychosocial care, and on 666 children (response rate 70.3%) from the community. Internal consistencies of the BTPS-exp total and subscales of both versions were good (lowest Cronbach's alpha = .85). Fit of the data with the assumed scale structure was acceptable. Correlation coefficients between the parent and adolescent scores were low (Pearson's r total scale = 0.25). Parents expecting multiple barriers was significantly more likely in non-Dutch ethnicity (odds ratio [OR] = 1.4; 95% confidence interval [CI] [1.1, 1.9]), in lower parental educational levels (primary education: OR = 3.0; 95% CI [1.5, 6.1]; lower-level secondary education: OR = 2.0; 95% CI [1.3, 3.1], both vs. university), in single parent families (1.3; 1.1-1.6), in case of child psychosocial problems (OR = 1.3; 95% CI [1.0, 1.5]) and in adolescents with psychosocial problems (OR = 2.1; 95% CI [1.4, 3.1]). Expecting multiple barriers did not affect the association between psychosocial problems and care enrollment. The authors conclude that the BTPS-exp has good psychometric properties regarding reliability and structure and is reasonably valid. Parents and adolescents have their own separate views, implying that it is valuable to assess both. Use of the scale might be helpful in providing direction to improve access to psychosocial care for children and adolescents. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Parents with a child suffering from psychosocial problems frequently experience barriers to psychosocial care, which may hinder access. Expectations of barriers may have the same effect, but evidence is lacking. The aim of this study is to examine parents' and adolescents' expectations of barriers regarding psychosocial care for the child, along with associated child and family characteristics. We obtained data on an age-stratified random sample of school children/pupils aged 4-18 via questionnaires (N = 666; response rate 70.3 %). Expectations of barriers to psychosocial care were measured with the "Barriers to Treatment Participation Scale-Expectancies" questionnaire (BTPS-exp). Results showed that 64 % of the parents of children below age 12, 59 % of the parents of adolescents (age 12-18), and 84 % of the adolescents expected one or more barriers. Parents and adolescents expected barriers most frequently with respect to irrelevance of treatment. Mainly parents with low educational level and their adolescents expected barriers regarding treatment, and quite a few characteristics of parents of adolescents were associated with expecting multiple barriers regarding treatment demands and issues, for example, single parents, parents of lower educational level and of adolescent boys, and parents of adolescents with psychosocial problems. We conclude that adolescents especially, but also their parents and parents of younger children, expect major barriers to psychosocial care, which may greatly hinder appropriate care seeking. This evidence may support professionals and policymakers in their attempts to improve access to psychosocial care.

Background: In patient-centred care, professionals should recognize their patient's needs and adapt their communication accordingly. Studies into patients' communication needs suggest priorities vary depending on sociodemographic characteristics, and type and severity of the complaints. However, evidence lacks on priorities in the communication needs of adolescents in psychosocial care and their parents., Objective: To assess adolescents' and parents' importance ratings concerning affective communication, information provision, shared decision-making, interprofessional communication and the degree to which client and care characteristics determine these., Methods: Adolescents aged 12-18 (n = 403) and one of their parents (n = 403) rated the importance of communication before the psychosocial care process started. Multivariable logistic regression analysis was applied to determine which characteristics were associated with the 25% lowest importance ratings for communication aspects., Results: Adolescents and parents considered affective communication to be the most important, with shared decision-making the least important. For adolescents, lower importance ratings were associated with dissatisfaction with prior care (OR 1.8), negative expectations (ORs 1.9-2.4), emotional problems (ORs 0.2-0.5) and low prosocial behaviour skills (ORs 2.0). For parents, low education (ORs 1.7-1.8), negative expectations (OR 0.4), adolescent's hyperactivity/inattention (ORs 0.4-0.5) and low prosocial behaviour skills (ORs 1.8-2.6) determined lower importance ratings., Conclusions: Affective communication has highest priority for adolescents and their parents. Client and care characteristics are associated with client priorities in communication. Being attentive to clients' educational level, previous care experiences, current expectations and specific problem types might help professionals to adapt better to their clients' communication needs., (© 2014 John Wiley & Sons Ltd.)

Knowledge about determinants of child and adolescent enrolment in psychosocial care concerns only single types of care and usually only socio-demographic factors. The social environment is also a likely key determinant but evidence is lacking. The aim of this study was to examine the associations between family social support, parenting skills and child and adolescent enrolment in psychosocial care. We obtained data on 1,331 children (response rate 56.6%), 4-18 years old, enrolled in preventive child health care, and child and adolescent social care and mental health care because of psychosocial problems, and on 463 children (response rate 70.3%) not enrolled in psychosocial care. Results showed that enrolment in psychosocial care was associated with low family social support (odds ratio; 95%-confidence interval: 3.2; 2.4-4.4), and with poor parenting skills, i.e. poor supervision (1.5; 1.1-2.1) and inconsistent disciplining (1.5; 1.1-2.1). Children's psychosocial problems partially mediated the associations with family social support and completely with parenting skills. Children's problems did not moderate the associations. Positive parenting was not associated with care enrolment. We conclude that low family social support and poor parenting are important factors associated with enrolment, in particular because they are associated with more frequent occurrence of children's psychosocial problems. This implies that professionals and policymakers need to be aware that factors in children's social environment are related with enrolment in psychosocial care, in addition to children's psychosocial problems.

\nPractical implicationsThe working alliance between families and professionals within the context of child protection faces substantial challenges from a variety of factors. At the same time, it plays an important role in accomplishing positive outcomes. To gain insight into what might contribute when establishing positive alliances between parents – undergoing formal parenting assessments – and family coaches, we interviewed 22 parents about their experiences with a Dutch family residential treatment (FRT) program. The majority of parents considered the approaches used in the program effective. A central theme identified concerns the importance of a connection between parents and coaches. Characteristics of professionals that promote this sense of connection include humanity, respectfulness, availability and responsiveness, and good communication skills. A sense of connection can help parents develop a relationship of trust in which they eventually feel safe enough to share their stories, insecurities, questions, emotions, and thoughts, all of which play an important role in achieving positive change within the family. Especially, parents valued individual conversations with coaches with whom they felt connected. They identified several strategies applied by the FRT-professionals as having helped them to make changes in parenting. We organized the key themes into a conceptual model for establishing positive working alliances promoting change. For parents there must be a match with the professional and personal qualities of family coaches in order to feel a connection with them.When insufficient connection is experienced, the model we developed can be helpful to find out what can be changed.According to parents, it is helpful to build a good working relationship if family coaches are not too “formal.”Interventions focusing on developing a good collaborative relationship between parents and coaches can be effective to restore parents’ trust in others and themselves.The environment of 24-h family residential treatment is ideally suited for the development of positive working relationships.For parents there must be a match with the professional and personal qualities of family coaches in order to feel a connection with them.When insufficient connection is experienced, the model we developed can be helpful to find out what can be changed.According to parents, it is helpful to build a good working relationship if family coaches are not too “formal.”Interventions focusing on developing a good collaborative relationship between parents and coaches can be effective to restore parents’ trust in others and themselves.The environment of 24-h family residential treatment is ideally suited for the development of positive working relationships. [ABSTRACT FROM AUTHOR]

Although parental problems and poor parenting are commonly associated with adolescents' admission to secure residential care, few studies examined these parental characteristics. This study aims to identify parental problems and strengths and their association with parenting styles for 64 of these parents. We assessed perspectives of both adolescents and their parent figures shortly after admission. Parents often report high levels of psychopathology for both mothers and fathers, respectively, including depression (54.7% and 39.1%), anxiety (29.7% and 12.5%), substance dependence (14.1% and 26.6%), antisocial behaviour (1.6% and 21.1%), and psychosis (11.0% and 9.4%). Parents also report high parenting stress specifically related to the behaviour of their child. In contrast to our expectations, most parents experience a high quality of life. Living in a 1‐parent family, being unemployed and having debts are most frequently mentioned risk factor combinations. We found limited support for the hypothesis that parents with more risk and less protective factors show poorer parenting. Parents with more psychopathology and parenting stress do show poorer parenting than parents without these problems. Based on our findings, we describe several implications for engaging and supporting parents of adolescents in secure residential care. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to describe the development and application of the KIPP-list of care activities. The acronym KIPP stands for Knowledge and Insight into Primary Processes. The instrument is intended as a tool for family coaches to systematically report care activities conducted in the Dutch family support programme Ten for the Future (in Dutch: Tien voor Toekomst). Design/methodology/approach -- The design of the instrument was based on the components of the programme and a literature search for similar instruments used in the Netherlands, complemented by a staff survey. A series of three studies was carried out to test the instrument's validity and user-friendliness, and to assess its potential for programme evaluation. Findings -- The majority of care activities were performed in cooperation with one or both parents alone, and less frequently with children or external professionals. Although the main focus of the work of the family coaches fell into the categories of "collecting information" and "working towards (behavioural) change" with families, the relatively high frequency of all the types of care contacts emphasises the intensity of this family support programme with a complex target group. Originality/value -- Data gathered with the instrument provided meaningful information by descriptive analysis. KIPP thereby proved its general feasibility in increasing insight into service provision. The instrument can be useful in several stages and on several levels of quality assurance and service optimisation, including reflective practice, supervision, team management and research. [ABSTRACT FROM AUTHOR]

This article reports findings from an empirical study of services for young people in residential child and youth care in the Netherlands. These services typically offer contextual, family-focused care. In evaluating service-outcomes 26 interviews were completed by parents and youth care workers. Levels of child and family functioning before and after treatment were compared. Pre- and post-treatment measurements were correlated with measures of family involvement during treatment. Our study indicates that positive outcomes after treatment were associated with parental involvement before the start of treatment, with parental contributions to decisions about treatment, with attention for parental responsibilities during treatment, with parental access to the residential group and with parental participation in treatment evaluations. [ABSTRACT FROM AUTHOR]