Search

Background: Previous studies have shown that social climate in therapeutic residential youth care (TRC) is important to the welfare of residents, staff, and assessing treatment outcomes. The most influential theory on social climate in residential settings is the theory of Moos. The measurement of the concepts and aspects of this theory using the Community Oriented Programs Environment Scale (COPES) has repeatedly been criticized regarding usability, validity, and reliability, especially for TRC. Objective: To improve the usability and psychometric quality of the COPES by shortening and refining the original subscale structure for usage in TRC. Methods: Four-hundred adolescents living in Norwegian TRC participated. We supplemented confirmatory factor analysis (CFA) with item response theory (IRT) to evaluate model fit, investigate factor loadings, and shorten scales to improve their psychometric qualities and usability in describing social climate in TRC. Results: The original subscales were not acceptable as evaluated by the criteria for CFA and IRT. By removing psychometrically weak items, the instrument was shortened to 40 items within the original ten subscales. This short version showed acceptable psychometric qualities based on both CFA and IRT criteria and the instrument retained its content validity. Finally, the original three higher-order dimensions was not supported. Conclusions: Compared to the original instrument, the refined 40-item version of the COPES represents a more usable instrument for measuring social climate in TRC. Future studies are needed to confirm the multifaceted refined short version in comparable samples of youth and staff to further investigate predictive value and construct validity.

Background: Despite poor school performance by adolescents in secure residential care and the potential importance of education during care, little is known about how to achieve academic success with these adolescents. Objective: Therefore, the aim of the present study is to assess adolescents' academic achievement during secure residential care and to identify factors that are associated with adolescents' achievement. Methods: In the present study, we have included a sample of 53 adolescents in secure residential care using information from the individual care plans, the adolescents themselves, and their teachers. Results: Contrary to our expectations, teachers report an average-to-good school performance for a majority of the adolescents (53.8%). Partly consistent with our expectations, students with an average intelligence level, good academic motivation, and/or relatively few externalizing behavioral problems show significantly better academic achievement than students with a low intelligence level, poor academic motivation, and/or many externalizing problems. The results also suggest that low intelligence and poor motivation predict academic achievement, both directly and indirectly, through an increased risk for externalizing problems. Unexpectedly, we did not find significant associations between teachers' interaction skills, student-teacher relationship quality, and adolescents' academic achievement. Conclusions: Considering our findings, future research should aim at interventions that focus on improving teachers' ability to handle poor academic motivation and externalizing behavioral problems.

Background: Although secure residential care has the potential of reducing young people's behavioral problems, it is often difficult to achieve positive outcomes. Research suggests that there are several common success factors of treatment, of which the client's motivation for treatment and the quality of the therapeutic relationship between clients and therapists might be especially relevant and important in the context of secure residential care. Objective: The objective of the present study was to explore the association of these potential success factors with secure residential care outcomes. Methods: A repeated measures research design was applied in the study, including a group of adolescents in a secure residential care center that was followed up on three measurements in time. Interviews and questionnaires concerning care outcomes in terms of adolescents' behavior change during care were administered to 22 adolescents and 27 group care workers. Outcomes in terms of adolescents' treatment satisfaction were assessed by the use of questionnaires, which were completed by 51 adolescents. Results: Adolescents reported some positive changes in their treatment motivation, but those who were more likely to be motivated at admission were also more likely to deteriorate in treatment motivation from admission to departure. Treatment satisfaction was associated with better treatment motivation at admission and with a positive adolescent-group care worker relationship. Conclusions: The results suggest that outcomes can be improved by a more explicit treatment focus on improving the adolescent's treatment motivation and the quality of the adolescent-care worker relationship during secure residential care. (Contains 6 tables.)

Family‐centred practice (FCP) has been suggested as a best practice for treating youth with emotional and behavioural difficulties in residential care. In this preregistered systematic review, we examined how FCP is operationalized and measured in residential youth care and which family outcomes are associated with FCP. Our systematic search in six databases identified 5784 articles. We analysed included articles by coding the operationalizations of FCP in the interventions and study measures. Further, we descriptively summarized relations between FCP and family outcomes. Thirteen articles met our inclusion criteria. In these articles, FCP was operationalized by five types of youth worker actions in interventions and was measured as five types of family involvement. Ten articles examined pre–post differences in family‐centred interventions. Only four articles analysed relations between FCP and a family outcome. Studies found some support for a positive association between FCP and whole‐family functioning, but overall, the association between FCP and family outcomes remains unclear. Our findings demonstrate that more research is needed that specifically examines different aspects of FCP and how they relate to family outcomes in residential youth care. Such studies can benefit from the conceptual model proposed for FCP in residential youth care interventions. [ABSTRACT FROM AUTHOR]

Helping children and parents remain together, despite significant parent or child problems, is a key objective of child welfare services. One option is to place whole families together into out-of-home settings. We searched peer-reviewed and gray literature and solicited input from international networks to identify the range of family placement programs available. We identified three key types of "shared family care." Shared Family Foster Care (SFFC) involves sharing of care and intensive modeling of effective parenting by a host family that engages in mentoring of the parent and parenting of the child. Shared Residential Care (SRC) programs involve sharing of care and intensive modeling of effective parenting by professional staff as they engage parents and children in what had often been child-only residential programs. Family Residential Treatment Programs (FRT) also place parents and children in residence together. FRT programs are often aligned with inpatient treatment units. Active programs that illustrate each type are described. Through this typology and detailed information of currently active shared family care programs, policymakers and program designers can consider which kinds of programs have the most potential for implementation and sustainability. [ABSTRACT FROM AUTHOR]

Long-term behavioral change is often difficult to achieve with adolescents staying in residential youth care. To achieve long-term behavioral change, we developed the Up2U training program to enhance these adolescents' intrinsic motivation for change. Based on motivational interviewing and solution-focused therapy, Up2U is designed for conducting one-on-one conversations with adolescents in residential youth care. The aim of this study is to evaluate the experiences that adolescents and care workers have had with Up2U. The results of semi-structured interviews show that, in general, the care workers were satisfied with Up2U. They identified the clarity, conciseness, and sample questions as positive elements of Up2U. In contrast, the care workers regarded the extensiveness and the implementation of Up2U as less positive. The adolescents also seemed to be positive about the use of Up2U during one-on-one conversations. In conclusion, although both care workers and adolescents were generally satisfied, there is still room for improvement. [ABSTRACT FROM AUTHOR]

Adolescents in secure residential care mostly suffer from serious behavioural problems, often accompanied by trauma and adverse family circumstances. This paper presents findings of a comparison of behavioural problems and risk factors of 255 boys and girls (aged 12 to 18 years) in secure residential care in the Netherlands and their association with behavioural problems. A cross‐sectional design and standardized questionnaires were used to measure behavioural problems and individual and familial risk factors. By using independent‐sample t tests, the severity of these factors in boys and girls was compared, and by using structural equation modelling (SEM), associations between these factors and behavioural problems were investigated. The findings of the study show that post‐traumatic stress disorder (PTSD) symptoms, maladaptive emotion regulation, impaired perceived competence and internalizing behavioural problems were more severe in girls than in boys. Boys experienced more severe externalizing behavioural problems and more family problems than girls. Maladaptive emotion regulation, PTSD symptoms, perceived competence and parenting problems were related to behavioural problems. The results indicate that treatment for girls should address PTSD symptoms, perceived competence and maladaptive emotion regulation and that extra attention for family problems in the treatment of boys is warranted. [ABSTRACT FROM AUTHOR]

Secure residential youth care facilities try to optimize their help by offering gender-specific treatment, in an attempt to achieve positive behavioral change in adolescents. In this study, we examined behavioral change in a sample of 239 Dutch adolescents (M age = 15.59 years, SD = 1.36 years, 54.9% girls) in secure residential care. Pretest, posttest and follow-up measurements were carried out for behavioral problems, PTSD symptoms, emotion regulation, perceived competence and family problems. Comparisons were made between girls in gender-specific care, and girls and boys in regular care. Missing data analyses revealed the dataset contained many missing values. Analyses were performed at group level, using MANCOVA, ANCOVA's and bootstrapped planned contrast, and at case level, using the Reliable Change Index. At group level, results revealed higher effectiveness of gender-specific care for girls compared to regular care for girls, only in diminishing externalizing behavioral problems. Overall, there were more similarities than differences in the effectiveness of gender-specific versus regular help. At individual level, 0–58% of the adolescents improved during their stay in secure residential care. However, most adolescents showed no change (25–88%) or even deterioration (0–39%). These results strongly emphasize the need for alternative interventions. [ABSTRACT FROM AUTHOR]

Background: In residential youth care, group care workers and teachers often serve as a mentor for individual adolescents. Although favorable mentoring relationships are associated with positive adolescent outcomes, few studies examined the role of mentoring in residential youth care. Objective: The present study aims to assess adolescents', care workers' and teachers' mentoring relationship needs in terms of their one-on-one conversations during residential care. Methods: We conducted structured interviews with eleven adolescents, ten group care workers and two teachers and content analysis to assess the data Results: All respondents are rather satisfied with their conversations, which are often concerned with how the adolescent is doing. Adolescents mostly consider their family and home-situation as difficult topics, while care workers mostly consider sexuality as a difficult topic to talk about. Although 'improvement' with the youth is often the aim, most adolescents report that they do not (know if they) show changes because of these conversations. Moreover, only one of the twelve professionals thinks that it is his core task to achieve behavior change with the adolescents. According to the professionals, conversations often aim at building a good relationship, coaching, determining treatment goals, and gaining insight into the adolescent. Adolescents prefer a mentor who is calm, has respect, listens, and is reluctant in giving advice. Most professionals do not use a specific method and doubt whether they want to have conversations according to a manual or support tool. Conclusions: Despite being rather satisfied, adolescents and professionals indicate several points for improvement of one-on-one conversations. [ABSTRACT FROM AUTHOR]

Behavioral change in adolescents is often an important aim of residential youth care, but difficult to achieve. Care workers can increase the intrinsic motivation of adolescents to change their behavior by applying Motivational Interviewing (MI). The aim of this study is to investigate whether there is a difference in workers' performance vis-à-vis adolescents before and after an MI training course. To measure this difference, we coded transcripts of audio recordings of one-on-one conversations between adolescents and workers, using the MITI 4.2.1 and MISC 2.5. We compared the transcripts made before the MI training course with the transcripts made after the training course. The results show that the 13 workers made significantly more use of MI adherent behaviors after the training course. Moreover, a trend toward using fewer MI non-adherent behaviors after the training was observed. The results suggest that workers are able to evoke more 'change talk' with adolescents after a training course. In conclusion, after attending a training course, workers are able to engage in conversations that are more in line with the MI-spirit. However, these are still not "real" MI conversations yet. We recommend to train workers more intensively in how to apply MI. [ABSTRACT FROM AUTHOR]

Despite the importance of training residential youth care professionals to increase their professional competences, little attention has been paid so far to the influence of training on the behaviour and skills of residential professionals. This study aims to gain greater insight into the effects of training on the skills of these professionals. We conducted a systematic literature review using the PsycINFO, Eric, SocIndex and Academic Search Premier databases. Within the 12 studies retrieved, the outcomes of nine different training programme were examined. These nine training programmes include The Solution Strategy (TSS), (Professional) Skills for Residential Child Care Workers (PSRCCW/SRCCW), Therapeutic Crisis Intervention (for Youth Care Worker) (TCIYCW/TCI), Child Teacher Relationship Training (CTRT), a Brief Training Program (BTP), Social Skills Training (SST), Behavior Analysis Services Program (BASP), Mental Health Training (MHT) and a Brief Training Manual (BTM). Our results demonstrate that some training programmes may produce positive outcomes for professionals after a training course. TSS (in both studies), PSFCCW, SRCCW, TCI, CTRT, BTP, SST, BASP and BTM programmes are associated with positive outcomes regarding improvements in professional's individual characteristics or improvements in the work environment. However, two studies also found negative outcomes with regard to decreases in the perceived recognition of youth care workers' value to the agency and a decrease in the knowledge and skills that they learned through training after 6 months (TSS [ Hickey, 1994 ] and PSRCCW). In addition, the most common 'other' outcome was a variable effect of training on the professionals' skills. Although we did find positive and negative training outcomes on the professionals' skills, none of the studies specified the training elements which caused these changes. More thorough empirical studies using an experimental or repeated case study design are needed to identify effective training elements which could further improve the effectiveness of interventions targeting youths in residential youth care. • Little knowledge available about training effects on the skills of professionals • Training may produce positive outcomes on the skills of professionals • Negative outcomes on the skills of professionals through training are limited found • Training can lead to unexpected outcomes on the skills of professionals. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies on effectiveness of therapeutic residential youth care (TRC) have indicated that, compared to short-term effects, long-term effects are less convincing. Moreover, there is limited evidence on how TRC achieves treatment goals: TRC remains too much of a "black box". To gain durable treatment results we need to know more about how results are achieved, rather than investigating the achieved results itself. One of the factors associated with this process of change is the social climate within TRC institutions. Up until now, no literature reviews about how social climate is affected by institution and youth characteristics, and how social climate affects outcomes has been performed. Objective To provide an overview of the literature on associations between determinants and social climate and between social climate and outcomes in TRC. Method We searched multiple databases with a predetermined set of search criteria in the years 1990 and March 2017. We identified 8408 studies and reduced the final sample to 36 studies. Most studies were empirical assessments with a correlational design and were conducted in Western countries. Results Effect sizes for the studies ranged from small to large and varied between and within studies. Most associations were found between social climate and positive outcomes. The most mentioned social climate constructs were: an open climate, support, and autonomy. Conclusions The results are challenging to summarize due to variations in the concepts and operationalizations of social climate. The organizational culture must support a social climate which is supportive, structured and caring, and provide youth with an environment to grow. A positive social climate must constantly be evaluated and recreated based on combining the perspectives of residents, staff and external perspectives. Highlights • An open climate, autonomy, and support are the most studied social climate concepts. • A strength-based treatment showed strong associations with positive social climates. • Youths diverse clinical profiles predicted negative perceptions of social climate. • Open climates, structure, growth, and support showed many positive outcomes in care. • Repressive staff behavior showed most associations with negative outcomes for youth. [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]

Residential treatment for youth includes both care, such as basic care-taking tasks and pedagogical child-rearing tasks, and cure elements, such as the therapeutic milieu and individual treatment plans. With these elements, residential treatment aims to achieve a healthy development and a decrease of the present problems with youth. However, achieving enduring change with youth after they have left residential treatment is a great challenge. This challenge can be explained by care workers’ difficulties to establish good, genuine therapeutic relationships with individual youth. Furthermore, it can be explained by the commonly used treatment approach to achieve behavior change with youth during residential care. In this paper, I suggest that higher long-term effectiveness of residential treatment can be achieved by applying a combination of three treatment approaches. First, by focusing on youth’s individual needs and intrinsic motivations using the Self-Determination Theory (SDT) perspective. Second, by using the Common Factors model as residential care element to promote professionals’ interpersonal skills and good, genuine therapeutic relationships with youth. Third, by applying the Motivational Interviewing (MI) approach as a residential cure element. By integrating these approaches as intervention components, it is very likely that residential treatment will contribute to more enduring behavior changes with youth. [ABSTRACT FROM AUTHOR]

The participation of young people in care and treatment decisions is regarded as an essential element in effective decision-making and care. Although care and treatment in juvenile justice facilities is, in the first instance, based on a coercive placement (i.e. non-participatory decision-making), it is likely that participation is also essential for young offenders during their stay in care. In our study, we interviewed 24 care professionals working in two different juvenile justice facilities in the Netherlands. Professionals understand what participation entails (e.g. informing, listening to, taking views into account), and how and why they can use participation in everyday practice. Typically, they link issues such as safety and existing boundaries when talking about participation in a coercive context. Based on our findings, we present a conceptual model of factors that seem to influence a young person’s participation process. These findings indicate that there is a need for the structural incorporation of youth participation into juvenile justice facilities in such a way as to consider the needs and perspectives of both young people and professionals. [ABSTRACT FROM AUTHOR]

Abstract: Participation in decision‐making procedures of young people in care is considered a key element that affects their current or future living circumstances and might improve the quality of decision‐making on and delivery of provided services. This narrative literature review, covering the period 2000–2016, focuses on the opportunities of young people to participate, the challenges and facilitators to participation, and the outcomes of care related to participation. Sixteen studies met our search criteria. Several studies show that young people seem to have limited possibilities to “meaningful” participation in decision‐making. Various challenges and facilitators in the participation process emerge with regard to the level of the young person, the professional, and the (sociocultural) context. None of the studies provides evidence for a connection between the “amount” of youth participation in decision‐making and/or treatment during the care process and the outcomes of residential care. Implications for research and practice are reflected upon. [ABSTRACT FROM AUTHOR]

While there is a large difference in the number of young inhabitants in the Netherlands and Germany, their child protection frameworks are quite similar. In both countries, child protection services are mainly focused on youth aged 0 to 18 and regulations are aimed at clients' responsibility and their active involvement during care. Youth care services consist of community-based services, day treatment and out-of-home care services, which include foster care and residential care. The history of out-of-home care services in both countries is characterized by similar developments. Over the last four decades, similar trends in residential care, towards more small-scale forms of residential care, smaller residential group sizes, and increasing professionalization of staff have emerged. Over the last two decades, a comparable trend towards increasing professionalization can be seen in the context of foster care in both countries. In addition, the number of youths in out-of-home care increased in both countries over the last decade, specifically in foster care. Over the last decade, more studies have been conducted in residential care than in foster care in both countries. Despite similar trends and developments in out-of-home care practice, research mainly shows differences in applied topics and methods between Germany and the Netherlands. [ABSTRACT FROM AUTHOR]

Abstract: Many adolescents who make the transition to adulthood experience problems after their departure from secure residential care. Research suggests that these young people are often in need of support after they have left secure care. Little is known about the experiences and perceptions of adolescents during and after this transition. The aim of this article is to assess these experiences for a group of 24 adolescents in the Netherlands that have left secure residential care. The results show, in line with previous studies, that many adolescents experience problems during their transition from secure care, especially with regard to finances, school and employment, and living arrangements. In contrast to other studies, a majority of the adolescents reports to have received support in the year following their departure. Relatively few adolescents move to independence after their departure, which suggests that many adolescents are not ready for making a true transition into adulthood yet. [Copyright &y& Elsevier]

• Using a person-centered approach identified two setting types and four youth groups. • Few social climate differences exist between family-style and larger group settings. • The youth group with severe problems experienced the social climate most negatively. • The family problems group perceive involvement positively in family-style settings. • Policymakers should reject the one size fits all approach in residential youth care. Limited research exists on how therapeutic residential youth care (TRC) achieves treatment outcomes. More specifically, little is known about the association between contextual factors such as treatment organization, youth characteristics, and experienced social climate in TRC. Therefore, this study aims to investigate differences between latent classes of TRC and youth characteristics and their association with a positive perceived social TRC climate. We applied a person-centered approach in a cross-sectional design with a sample of 400 adolescents and 142 staff leaders. We analyzed youth and TRC characteristics in a latent class analysis and established associations with social climate for these two groupings. The two types of TRC settings we found, i.e., larger TRC settings and family-style TRC settings, show small differences in social climate. These settings only differed on youth activities and staff shifts type (more cohabitation and unorganized activities outside TRC in family-style TRC). We identified four adolescent classes: A severe problems group, youth with incidental problems, family problems, and a migrant background group. The migrant background group showed the most positive perceptions of social climate, followed by youth with incidental problems, family problems, and severe problems. TRC staff should acknowledge how perceived social climate is connected to TRC characteristics and the heterogeneity of adolescents in care. As social climate is subjective and dynamic, a continuous dialogue about TRC social climate between staff and youth is recommended. Future research should investigate how these aspects are associated with treatment outcomes to increase our understanding of achieving positive outcomes in TRC. [ABSTRACT FROM AUTHOR]

Abstract: Residential child and youth care is a radical intervention that in many countries is perceived as a ‘last resort’ solution that should be avoided if at all possible — not least because of scepticism about its effectiveness. Against this, there is the view that a residential placement can contribute to the positive development of some youth with serious behavioral and/or emotional disturbances. In this context, it is remarkable that there are so few reviews and meta-analyses of outcomes of residential child and youth care services. In this article, we report on research into outcome studies published in the period 1990–2005. The application of strict inclusion and selection criteria yielded 27 pre- and quasi-experimental studies (PE and QE) covering the development and outcomes for 2345 children and young persons. Since there is variation in the outcome measures, we give an integral overview of all the individual ES''s in the studies. However, for seven studies with a PE-design it was possible to calculate an overall ES: the weighted mean effect sizes ranged from .45 (internalized problem behavior) to .60 (externalizing problem behavior; behavior problems in general). QE-studies prove that residential programs applying behavior-therapeutic methods and focusing on family involvement show the most promising short term outcomes. There is very little evidence on long term outcomes of residential care. It also strikes us that many studies lack a specific description of the residential intervention program. [Copyright &y& Elsevier]