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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.

Most youth in residential youth care institutions have a long history of adverse childhood experiences, and show (severe) emotional, behavioral, and academic problems. The present study used adoles...

Repression in residential youth care institutions can manifest itself openly in coercive measures or may be concealed in staff behavior that is endemic to residential youth care, such as soft power and strict behavioral control (i.e., structure), which threatens rehabilitative goals and might even violate children’s rights. To increase awareness of particularly the more hidden aspects of repression, this qualitative study follows the framework method to examine processes that cause adolescents to experience repression. Semistructured interviews were conducted with an ethnic diverse sample of 32 adolescents from open, secure, and forensic (i.e., youth prisons) residential youth care institutions in the Netherlands. Results indicated that adolescents tend to accept structure, rules, coercion, and punishments, and that they expect staff to use their power to create order and safety. However, results also showed that restrictive measures may be approved by adolescents to cope with repression, taking the form of rationalization. Staff behavior perceived as unfair or excessive by the adolescents was conceived of as repressive. Respect for autonomy and providing treatment that is experienced as meaningful by the adolescents seem to decrease experienced repression.

The present study examines the relation between classroom climate in schools for secondary special education and students' perceived social exclusion. A total of 401 Dutch adolescents (70.3% males) with conduct problems, attending schools for special education, filled out questionnaires on classroom climate, problems in social information processing, externalizing behavior and perceived social exclusion. Results showed that a positive classroom climate was associated with a reduction of students' externalizing behavior problems and perceived social exclusion, which was associated with improvements in social information processing. However, these relations were only found at the within group level of analysis (between students) and not at the between group level (between classes); thus contextual (class level) effects could not be demonstrated. It can be carefully stated that a positive classroom climate in secondary special education may protect against perceived social exclusion. Future research is required to examine whether our findings can be replicated in other schools for secondary special education or can be generalized to secondary education in general.

Developing autonomy is a pre-requisite for meaningful participation in society. However, youth leaving secure residential youth care (SRYC) relate that treatment does not prepare them well enough to stand on their own feet. Too often these youth are not involved in decisions regarding their own life and future. The original aim of the present study was to develop an instrument for youth leaving SRYC that evaluates the development of autonomy and participation and puts their perspective central. We chose for participatory design-based research. Several design and evaluation cycles were followed using a combination of qualitative research methods. First, the design requirements regarding purpose, form, and content of the instrument were developed in an iterative process with youth and staff. An important result was that the purpose had to be changed. Youth needed a tool supporting the development of autonomy and participation. The tool was designed and called My Path, and invites youth to reflect on what they want with their life and future and to work on this future in small steps. An instruction manual for professionals explains how to put the youth in the lead while they seek and follow their path. A pilot study provided evidence for the usability and trustworthiness of this method to strengthen autonomy and meaningful participation for youth in SRYC. My Path appeared more broadly applicable due to its normalizing approach. In-depth training of professionals is needed to work with My Path while making sure the youth is steadily in the lead. https://doi.org/10.1007/s43151-020-00029-x

The aim of the present study was to examine differences in perceived living group climate between boys and girls in a sample of 344 youth (68.6% male, M age = 16, SD = 1.58) receiving residential youth care in the Netherlands. Participants filled out self-report measures on living group climate. Results of multilevel regression models indicated that girls in non-correctional facilities experienced living group climate most positively, and girls in correctional facilities experienced living group climate most negatively compared to girls and boys in non-correctional facilities. We conclude that residential treatment settings should adapt gender-responsive approaches to address specific needs of girls, specifically in secure residential care. Future studies should focus on specific needs of girls to advance knowledge on how they can benefit optimally from their stay in residential care to facilitate gender-specific programming in residential youth care.

To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The aim of this study is to advance our understanding of key components of integrated Youth Care from a parental perspective.Semi-structured interviews were administered to 21 parents of children receiving Youth Care from integrated care teams in the Netherlands. Qualitative content analysis was conducted by means of a grounded theory approach following qualitative reporting guidelines.Parental perspectives were clustered into six key components: a holistic, family-centred approach; addressing a broad range of needs in a timely manner; shared decision making; interprofessional collaboration; referral; and privacy. Parents emphasized the importance of a tailored, family-centred approach, addressing needs across several life domains, and active participation in their own care process. However, they simultaneously had somewhat opposing expectations regarding these key components, for example, concerning the changing roles of professionals and parents in shared decision making and the value of involving family members in a care process. Professionals should be aware of these opposing expectations by explicitly discussing mutual expectations and changing roles in decision making during a care process. To enable parents to make their own decisions, professionals should transparently propose different options for support guided by an up-to-date care plan.

Even though Parenting Capacity Assessments (PCAs) are essential for child protection services to support placement decisions for maltreating families, presently no evidence-based PCA protocols are available. In this randomized controlled trial, we tested the quality of an attachment-based PCA protocol based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We recruited 56 parent-child dyads (MA pesar de que las Evaluaciones de Capacidad de Crianza (PCA) son esenciales para los servicios de protección al niño para apoyar las decisiones de dónde colocarlo por razones de familias maltratadoras, en el presente no se encuentran disponibles ningún protocolo PCA basado en la evidencia. En este ensayo controlado al azar, pusimos a prueba la calidad de un protocolo PCA basado en la afectividad para lo cual nos basamos en la Intervención de Video Informativo para promover una Crianza Positiva y Disciplina Sensible (VIPP-SD). Reclutamos 56 díadas de progenitor-niño (edad promedio de los niños = 3.48 años) en clínicas residenciales de familias holandesas que utilizan las PCA para apoyar las decisiones de dónde colocar. Después del pre-examen, las familias fueron asignadas al azar para recibir el Procedimiento de Evaluación Regular (RAP) (n = 28), o una evaluación adicional basada en VIPP-SD (n = 28). Se llevaron a cabo un examen posterior inmediato y un seguimiento a los 10 meses. Los modelos de niveles múltiples mostraron que los terapeutas se sintieron igualmente confiados acerca de sus recomendaciones con respecto a dónde colocar al niño en ambos grupos y que ellos igualmente modificaron a menudo su recomendación inicial de dónde colocarlo. Es más, los niños en el grupo VIPP-SD no mostraron menos problemas de conducta y no experimentaron maltrato infantil recurrente menos a menudo que los niños en el grupo RAP. Por tanto, no encontramos evidencia de que las PCA que incorporan el protocolo VIPP-SD tuvieran mejores resultados que las PCA en su forma usual. Discutimos posibles explicaciones de por qué en el presente estudio los VIPP-SD no parecieron agregar nada a la calidad de RAP.Contexte: Des interventions favorables et ciblées pour les familles sont nécessaires afin d'optimiser l'ajustement parental et la relation parent-bébé conformément à un diagnostic précédant de risque neurodéveloppemental pour les bébés. Buts: Le but de cette revue systématique était de déterminer l'efficacité des interventions pour l'amélioration de l'ajustement psychologique et le bien-être pour les parents ayant un bébé ayant été diagnostiqué comme ayant ou étant à risque d'avoir un trouble neurodéveloppemental. Méthodes: La stratégie de recherche du Cochrane Review Group a été suivie avec une recherche des essais contrôlés du Registre Cochrane Central, de PubMed, CINAHL, PsycINFO, et Embase entre juillet et décembre 2017. La qualité méthodologique des articles inclus a été évaluée au moyen de l’échelle de la base de données de preuve de physiothérapie (PEDro Physiotherapy Evidence Database) par deux évaluateurs indépendants. Résultats: Douze études ont rempli les critères d'inclusion. Un petit nombre d'essais de grande qualité ont révélé une efficacité modérée à importante de la réduction chez les parents de symptômes psychologiques indésirables de trauma et de stress des parents. Des améliorations importantes dans les symptômes de dépression et d'anxiété ont émergé lors de follow up post intervention à plus long terme (6 mois-8 ans). Conclusions: On constate un soutien prometteur pour l'efficacité de certaines interventions à réduire les symptômes psychologiques de mésadaptation chez les parents avec des bébés diagnostiqués comme étant à risque d'un trouble neurodéveloppemental. D'autres ECR de qualité d'intervention psychologiques portant sur les conditions plus grandes de risque neurodéveloppemental sont nécessaires.Die Wirksamkeit einer bindungsbasierten Intervention zur Beurteilung der elterlichen Kapazitäten in Familien mit häuslicher Gewalt: Eine randomisierte kontrollierte Studie Eine Beurteilung der elterlichen Kapazitäten (Parenting Capacity Assessments; PCAs) ist für die Kinder- und Jugendhilfe unerlässlich, um Entscheidungen zur Unterbringung von Kindern zu treffen, die von häuslicher Gewalt betroffen sind. Trotzdem sind derzeit keine evidenzbasierten PCA-Protokolle verfügbar. In dieser randomisierten kontrollierten Studie haben wir die Qualität eines bindungsbasierten PCA-Protokolls untersucht, das auf einer Video-Feedback-Intervention basiert, um positive Erziehungskompetenz und sensibles Maßregeln (Positive Parenting and Sensitive Discipline; VIPP-SD) zu fördern. Wir haben 56 Eltern-Kind-Dyaden (mittleres Alter der Kinder = 3,48 Jahre) in niederländischen Familienheimkliniken rekrutiert, in denen PCAs durchführt werden, um Entscheidungen zur Unterbringung von Kindern zu treffen. Nach dem Prä-Test wurden die Familien randomisiert und erhielten entweder das reguläre Beurteilungsverfahren (Regular Assessment Procedure; RAP) (n = 28) oder eine zusätzliche Beurteilung basierend auf VIPP-SD (n = 28). Nach der Beurteilung folgte ein sofortiger Post-Test und nach 10 Monaten ein Follow-up. Multilevel Modelle ergaben, dass sich die Therapeut_innen hinsichtlich ihrer Empfehlungen zur Unterbringung der Kinder in beiden Gruppen gleichermaßen sicher fühlten und dass sie ihre erste Unterbringungsempfehlungen gleichermaßen häufig revidierten. Darüber hinaus zeigten Kinder in der VIPP-SD-Gruppe nicht weniger Verhaltensprobleme und erlebten nicht seltener wiederkehrende Misshandlungen als Kinder in der RAP-Gruppe. Daher fanden wir keine Hinweise darauf, dass PCAs, die das VIPP-SD-Protokoll enthalten, gegenüber den üblichen PCAs einen Vorteil haben. Mögliche Erklärungen, warum VIPP-SD in der vorliegenden Studie die Qualität des RAP nicht zu verbessern schien, werden diskutiert.虐待する家族の育児能力の評価におけるアタッチメントに基づく介入の効果:ランダム化比較試験 育児能力評価(PCAs) は、児童保護サービスにとって、虐待する家族に対しての 配置決定を裏付けるために必要不可欠であるが、現在エビデンスに基づくPCAプ ロトコルはない。本研究のランダム化比較試験において、我々は、“積極的な子 育てと繊細なしつけを促進するためのビデオ・フィードバック介入(VIPP-SD)”を 基にしたアタッチメントに基づくPCAプロトコルの質をテストした。我々は、配 置決定を裏付けるPCAsを実施しているオランダの家族滞在クリニックで、56組の 親子 (子どもの平均年齢:3.48歳) を採用した。事前テスト後、家族は通常の評 価手順(RAP) (n = 28)を受けるか、VIPP-SDを基にした追加の評価(n = 28)を受 けるかを、無作為に選ばれた。直後のテストと10ヶ月のフォローアップが実施さ れた。マルチレベルモデルは、セラピストが両グループとも子どもの配置に関す る自分たちの提案に等しく自信を感じていること、また自分達の最初の配置提案 を等しい頻度で変更していることを示していた。さらに、VIPP-SD グループの子 ども達は、RAPグループの子ども達より、より少ない行動問題を示すということ はなく、またより少ない児童虐待の再発を体験しないということもなかった。以 上のように、VIPP-SD プロトコルを取り入れたPCAs が、通常のPCAs より優れて いるという証拠は見られなかった。本研究においてVIPP-SDがRAPの 質を向上さ せるように見られなかった理由について考えられる解釈を議論する。.尽管育儿能力评估 (PCAs) 对儿童保护服务至关重要, 以支持虐待型家庭的安置决策, 但目前还没有循证PCA方案。在这项随机对照试验中, 我们测试了基于“积极养育和敏感管教的视频反馈干预 (VIPP-SD)”的PCA干预方案的质量。我们在荷兰家庭寄宿诊所招募了56对母婴 (儿童平均年龄 = 3.48) 进行PCAs以支持安置决策。经过预测试后, 家庭被随机分配以接受常规评估程序 (RAP) (n = 28), 或根据VIPP-SD (n = 28) 进行额外评估。开展了一次即时后测和10个月随访。多层次模型显示, 治疗师对两组儿童安置的建议同样有信心, 而且他们同样经常修改最初的安置建议。此外, 与RAP组相比, VIPP-SD组的儿童没有表现出更少的行为问题, 也没有经历反复的儿童虐待。因此, 我们没有发现任何证据表明, 采用VIPP-SD方案的PCAs的质量优于常规PCAs。我们讨论了可能的解释, 为什么在目前的研究中VIPP-SD似乎没有增加RAP的质量。.التعلق وتنظيم الإجهاد عند الأطفال المحرومين اجتماعيا ً واقتصادياً: هل تقدم رعاية الأطفال العامة التعويض المطلوب؟ الأطفال الذين ينشأون في أسر تعاني من الحرمان الاجتماعي والاقتصادي (SED) هم أكثر عرضة للعجز في التعلق وتنظيم الإجهاد مقارنة بأقرانهم في الأسر ذات الموارد الاجتماعية والاقتصادية الأكثر. افترضت هذه الدراسة أن مقدمي الرعاية في الرعاية العامة للأطفال قد يساعدون هؤلاء الأطفال على التعويض. ولذلك قمنا بالتحقيق مع 60 طفلاً (30 طفل من الفئات المحرومة اجتماعيا واقتصاديا و30 طفل من الطبقة المتوسطة) وقيمنا تعلق الأطفال(AQS) بالأم ومقدم الرعاية الأولية في مراكز رعاية الطفل العامة. وعلاوة على ذلك، تم قياس إيقاع الكورتيزول اليومي للأطفال على أساس 12 عينة من اللعاب تؤخذ عبر ثلاثة أيام في الأسبوع. وأظهر الأطفال المحرومون درجات أقل على مقياسAQS مع أمهاتهم مقارنة بمقدمي الرعاية. بالمقارنة مع نظرائهم، أظهر الأطفال المحرومون أيضًا إفراز كورتيزول متزايد وملامح الكورتيزول التملقية التي تعكس أنشطةHPA العالية بشكل عام وقدرات أقل لتنظيم الإجهاد. وأبرزها ومع ذلك، ربط نمذجة المسار متعدد المستويات أعلى مستوى الرعايةAQS عشرات لخفض الإفراج الكورتيزول على مدار الأسبوع.

To overcome fragmentation in support for children and their families with multiple and enduring problems across life domains, professionals increasingly try to organize integrated care. However, it is unclear what facilitators and barriers professionals experience when providing this integrated care. Our systematic review, including 55 studies from a broad variety of settings in Youth Care, showed that integrated care on a professional level is a multi-component entity consisting of several facilitators and barriers. Findings were clustered in seven general themes: ‘Child’s environment’, ‘Preconditions’, ‘Care process’, ‘Expertise’, ‘Interprofessional collaboration’, ‘Information exchange’, and ‘Professional identity’. The identified facilitators and barriers were generally consistent across studies, indicating broad applicability across settings and professional disciplines. This review clearly shows that when Youth Care professionals address a broad spectrum of problems, a variety of facilitators and barriers should be considered. Registration PROSPERO, registration number CRD42018084527. Electronic supplementary material The online version of this article (10.1007/s10488-020-01049-8) contains supplementary material, which is available to authorized users.

In this multilevel meta-analysis the outcomes of adolescents with complex problems at risk for school drop-out attending nonresidential alternative educational facilities were examined. Ten studies (87 effect sizes), examining outcomes on social-emotional functioning, academic achievement, academic attitude, externalizing and internalizing problems, were included. The findings indicated a small but significant overall effect (d = 0.15, p =.03), providing preliminary evidence that these facilities may be associated with positive outcomes for adolescents. Study quality, measurement type and reliability of the assessment instruments were significant moderators of the overall effect size. Results of this study urge for more high quality research on nonresidential alternative educational facilities, because they can contribute to positive youth outcomes, which in turn may prevent school drop-out and other negative life outcomes.

Introduction: To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The aim of this study is to advance our understanding of key components of integrated Youth Care from a parental perspective. Methods: Semi-structured interviews were administered to 21 parents of children receiving Youth Care from integrated care teams in the Netherlands. Qualitative content analysis was conducted by means of a grounded theory approach following qualitative reporting guidelines. Results and discussion: Parental perspectives were clustered into six key components: a holistic, family-centred approach; addressing a broad range of needs in a timely manner; shared decision making; interprofessional collaboration; referral; and privacy. Parents emphasized the importance of a tailored, family-centred approach, addressing needs across several life domains, and active participation in their own care process. However, they simultaneously had somewhat opposing expectations regarding these key components, for example, concerning the changing roles of professionals and parents in shared decision making and the value of involving family members in a care process. Professionals should be aware of these opposing expectations by explicitly discussing mutual expectations and changing roles in decision making during a care process. To enable parents to make their own decisions, professionals should transparently propose different options for support guided by an up-to-date care plan. Publisher's Note: A correction article relating to this paper has been published and can be found at http://doi.org/10.5334/ijic.5613

Treatment motivation in secure residential youth care is assumed to be a necessary condition for effective treatment, and is therefore a key element in the reduction of problem behavior and criminal recidivism. According to Self-Determination Theory (SDT) three basic psychological needs (autonomy, competence and relatedness) are essential for treatment motivation, which are characteristics of a positive residential group climate. Based on SDT, we examined whether a therapeutic (open) group climate and low levels of institutional repression were associated with treatment motivation of adolescents residing in (semi-) secure residential youth care facilities. An ethnically diverse sample was studied of 179 respondents (M=16.2years; SD=1.5), in 12 Dutch (semi)secure youth care facilities and 9 forensic youth care institutions. We measured residential group climate with the PGCI and treatment motivation with the ATMQ, and fitted a Cross-Lagged Panel Model (CLPM) of residential group climate and treatment motivation. It was found that a positive group climate in the first month after placement predicted greater treatment motivation three months later.

Background To meet the needs of high-vulnerable families with severe and enduring problems across several life domains, professionals must improve their ability to provide integrated care timely and adequately. The aim of this study was to identify facilitators and barriers professionals encounter when providing integrated care. Methods Experiences and perspectives of 24 professionals from integrated care teams in the Netherlands were gathered by conducting semi-structured interviews. A theory-driven framework method was applied to systematically code the transcripts both deductively and inductively. Results There was a consensus among professionals regarding facilitators and barriers influencing their daily practice, leading to an in depth, thematic report of what facilitates and hinders integrated care. Themes covering the facilitators and barriers were related to early identification and broad assessment, multidisciplinary expertise, continuous pathways, care provision, autonomy of professionals, and evaluation of care processes. Conclusions Professionals emphasized the need for flexible support across several life domains to meet the needs of high-vulnerable families. Also, there should be a balance between the use of guidelines and a professional’s autonomy to tailor support to families’ needs. Other recommendations include the need to improve professionals’ ability in timely stepping up to more intensive care and scaling down to less restrictive support, and to further our insight in risk factors and needs of these families.

Repression in residential youth care institutions threatens youth’s positive development. When youth experience arbitrary use of power, structure, or coercion, this may cause demotivation, reactance or aggression, and diminished chances of rehabilitation in youth. Because institutional repression may be hard to recognize, a valid and reliable measurement instrument is necessary to signal repression in residential institutions. This article outlines the conceptualization, development and validation of the Institutional Repression Questionnaire in a sample of 180 youth (aged 12–24, 32% female) staying in open, secure, and forensic residential youth care institutions. The Institutional Repression Questionnaire is a self-report questionnaire, designed to measure five dimensions of repression: abuse of power, injustice, lack of autonomy, lack of meaning, and dehumanization. The multicomponent structure was confirmed in a confirmatory factor analysis, resulting in 24 items in five subscales: Abuse of Power, Justice, Lack of Autonomy, Meaning, and Humanization. One open-ended question is part of the questionnaire to invite youth to disclose more extreme cases of repression. Convergent validity was established via correlations between the Institutional Repression Questionnaire and the Prison Group Climate Inventory—as a measure of living group climate in residential institutions—and the Basic Psychological Need Satisfaction and Frustration Scale-Intellectual Disability—as a measure of self-determination. The five Institutional Repression Questionnaire subscales demonstrated good internal consistency. The study provides preliminary evidence to support validity and reliability of an adolescent self-report questionnaire of perceived institutional repression as a multidimensional construct. Residential youth care institutions can use outcomes of the Institutional Repression Questionnaire to improve their living group climate.

The current study investigated the effect on recidivism of treatment aimed at juveniles who have sexually offended. It also assessed the potential moderating effect of type of recidivism, and several treatment, participant and study characteristics. In total, 14 published and unpublished primary studies, making use of a comparison group and reporting on official recidivism rates, were included in a multilevel meta-analysis. This resulted in the use of 77 effect sizes, and 1,726 participants. A three-level meta-analytic model was used to calculate the combined effect sizes (Cohens d) and to perform moderator analyses. Study quality was assessed with the EPHPP Quality Assessment Tool for Quantitative Studies. A moderate effect size was found (d = 0.37), indicating that the treatment groups achieved an estimated relative reduction in recidivism of 20.5% as compared to comparison groups. However, after controlling for publication bias, a significant treatment effect was no longer found. Type of recidivism did not moderate the effect of treatment, indicating that treatment groups were equally effective for all types of recidivism. Also, no moderating effects of participant or treatment characteristics were found. Regarding study characteristics, a shorter follow up time showed a trend for larger effect sizes, and the effect size calculation based on proportions yielded larger effect sizes than calculation via mean frequency of offending. Implications for future research and clinical practice are discussed.

This multilevel meta-analysis examined the effects of treatment for juveniles with harmful sexual behavior on psychosocial functioning, and the potential moderating effects of outcome, treatment, participant, and study characteristics. In total, 23 studies, comprising 31 independent samples and 1342 participants, yielded 362 effect sizes (Cohen's d). A moderate overall effect size was found of d = 0.60, indicating that groups receiving treatment achieved an estimated relative improvement in psychosocial functioning of 33%. Type of outcome did moderate the effect of treatment, indicating that effects on atypical sexual arousal and empathy (a trend) were smaller, compared to effects on other outcomes. Most prominently, studies of weak quality produced larger effect sizes. Unexpectedly, non-established treatments had more effect than did established treatments, which may be explained by the use of less rigorous study designs. Treatment groups with a higher percentage of juveniles with similar age victims or mixed type problem behavior also yielded larger effect sizes. Lastly, evaluation of treatment effects by professionals produced higher effect sizes, compared to other sources of information (e.g., adolescent self-report). Although only a marginal to no indication was found for publication bias by means of funnel plot analysis of the distribution of effect sizes, articles published in peer reviewed journals showed relatively large effect sizes. Implications for future research and clinical practice are discussed.

As a counterreaction to projects attracting the creative class, other projects have stimulated the craft-based talents of poor neighborhood residents. One example is the Freehouse Foundation in Rotterdam. Freehouse facilitated cooperation between residents and designers and artists. We investigated whether Freehouse improved the social inclusion of these residents. We conclude that Freehouse’s efforts to connect arts and crafts resulted in collaborative creative production, with primarily social benefits for the residents. Initiatives such as Freehouse can offer a contribution to social inclusion, albeit a small one. However, connections between arts and crafts are only likely to occur if explicitly established.

Similarities and differences in the (short-term) psychosocial development of children in foster care, family-style group care, and residential care were investigated in a sample of 121 Dutch children (M age = 8.78 years; SD = 2.34 years; 47% female; 59% Caucasian) one year after their initial placement. Pretest and posttest measurements were carried out at the substitute caregivers using the CBCL. The results were examined at group level and case level. At group level, the findings showed no evidence for higher effectiveness in favor to the family-oriented settings (foster care, and family-style group care), as hypothesized. By contrast, some small differences were found between foster care and family-style group care, in favor of the latter. At individual level, a more or less equal number of children (18%) with a clinical pretest score on psychosocial functioning clinically significant improved (behavioral normalization). An important concern is that a number of children without clinical psychosocial problems at the time of admission clinically significant deteriorated (behavioral aberration) in psychosocial functioning (20%). This might indicate a poor match between the risks, needs and responsivity of the child on the one hand and the chosen intervention on the other. Future research on factors that (prior and during placement) positively as well as negatively affect the child’s psychosocial development is needed to further clarify this finding.

Het project Lerend Transformeren heeft als doel door middel van actieonderzoek professionals en hun organisaties te ondersteunen bij het ontwikkelen van een nieuwe werkstijl die past bij de transformatiedoelen. In deze bijdrage wordt dit project als voorbeeld belicht om te laten zien hoe actieonderzoek kan bijdragen aan de transformatie in de jeugdzorg.

To date, no evidence-based criteria are available to place children with multiple psychosocial risks and needs in the most appropriate type of (non-secure) out-of-home care. Due to this, other factors than just the clinical needs of the child and its family are in use, which can heighten the risk of both breakdown (i.e. unplanned terminated placement) and/or poor prognostic placement outcomes. To reduce adverse placement outcomes, insight into the risks and needs of the children at the time of referral can be helpful. To this end, this study explores similarities and differences in child, family and care history context of 200 Dutch school-aged children at the time of admission to foster, family-style group, and residential care. A cross-sectional design was used and data were collected through standardized questionnaires that were completed by the caregivers, substitute caregivers, and behavioral scientists. Case file information was also used. The results showed differences between the three subgroups in all three contexts, which suggest several setting-specific guidelines to promote positive outcome. Biological parents of foster children specifically are in need of support for their individual problems. In family-style group care, specifically, help is required for attachment and trauma-related problems. Residentially placed children are in particular need of specialized care for mental illness, behavioral and school/learning problems. Further research is needed to link the outlined specific characteristics at admission to the developmental pathways of out-of-home placed children. Such research may contribute to the development or refinement of a risk-need-responsivity model to support the decision making regarding out-of-home placement of children with serious psychosocial needs.

This study examined the internal structure, convergent validity, and reliability of the student self-report Special Education Classroom Climate Inventory (SECCI) in a sample of 325 students attending special education classes in six (semi) secure residential settings and in two youth prisons in the Netherlands. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) provided evidence of a theoretically based four-factor model—with Teacher Support, Positive Student Affiliation, Negative Student Interactions, and Unstructured Classroom Environment as dimensions—showing an adequate fit to the data, providing preliminary support for validity of the SECCI. Limited evidence for convergent validity was found in significant but small associations between classroom climate and academic self-concept. Ordinal Cronbach’s alpha reliability coefficients were good for all factors. The SECCI might be used to assess and subsequently target (problematic) classroom climate in schools for special education for students in (secure) residential youth care and youth prisons, although further development of the SECCI and replication of our study results seem necessary.

Introduction: Youth Care professionals support children and their families who experience a variety of problems on multiple life domains, including psychosocial impairments, problems with alcohol and drugs, parental stress, child abuse and socioeconomic disadvantages (Kolko & Perrin, 2014; Tausendfreund et al., 2016). To overcome fragmentation in, and improve the quality of Youth Care, there has been an increased focus on organizing integrated care. Although providing integrated care requires processes on different complementary levels (Valentijn, Schepman, Opheij, & Bruijnzeels, 2013), previous research has tended to focus on integrated care at organizational and clinical levels, disregarding the substantial influence of integrated care on a professional level (Sunderji, Waddell, Gutpa, Soklardis, Steinberg, 2016). The aim of the current systematic review, therefore, is to identify facilitators and barriers in providing integrated Youth Care on a professional level. Methods: Prior to the review process, a research protocol was formulated and registered (PROSPERO, registration number CRD42018084527). A systematic literature review of studies published between 2002 and 2018 was executed (PubMed, The Cochrane Library, Web of Science, Medline and PsychINFO). Search strategy was developed in collaboration with an experienced medical research librarian, supplemented with literature obtained from the IFIC Integrated Care Search. Included studies focused on processes on a professional level regarding integrated care in YC for children (age ≤ 18 years) and their families. Two researchers independently screened potential relevant studies. After critical appraisal, qualitative synthesis was conducted to identify facilitators and barriers for professionals in providing integrated care. Results: 55 studies were included in this review, varying in quality and design. Narrative synthesis was performed to systematically describe and compare facilitators and barriers, in order to explore patterns in the data. The coded barriers and facilitators were clustered in seven overarching themes, including interprofessional collaboration, expertise and professional identity. Conclusion, discussion and lessons learned: Providing integrated Youth Care is a multicomponent and complex process, with several complementary barriers and facilitators that seem of substantial importance for Youth Care professionals. Although some facilitators and barriers are more frequently found in literature than others, appraising their evidence is complicated considering the wide variety of study methods and quality of studies. Results from this review offer insights and recommendations for Youth Care professionals and policy makers in providing integrated care in practice. Limitations: Due to the heterogeneity of the terminology in the field of integrated care and Youth Care, we used a broad scope of search terms, striving for an adequate coverage of the literature available and increasing the applicability of the results. However, it is important to acknowledge that there is a possibility that some studies were overlooked. Besides, there is a wide variety in quality and robustness of the included studies, resulting in information that is extensive, but difficult to compare. Suggestions for future research: This review is part of a comprehensive practice based action research to integrated care. Future research is needed to compare findings from this literature study to results from action based research on integrated care in practice.

Introduction: Since the new Youth Act came into force in January 2015, there has been a decentralization of the Youth Care system in the Netherlands to local municipalities. By decompartmentalization of budgets, municipalities aim to reduce fragmentation of the Youth Care system and facilitate integrated care on a local level. However, despite major organizational and financial changes, there are indications that these changes itself are insufficient to accomplish integrated care in practice. There is a need for practice based knowledge regarding facilitators and barriers on a professional level in providing integrated care in Youth Care practice. Aim: The aim of this study is to identify facilitators and barriers in providing integrated care directly from Youth Care practice and to stimulate professionals to learn and improve the quality of integrated care. Theory of change and short description of practice change implemented: The overall research method of this practice-based study is action research, with Youth Care professionals as fellow researchers and a strong focus on active involvement of important stakeholders, including policy makers and parents. By qualitative research methods, including weekly observations and semi-structured interviews with 24 professionals and 21 parents, facilitators and barriers regarding integrated care are collected directly from practice. Continuous feedback of these results is provided to Youth Care professionals and policy makers, in order to improve the current practice. Targeted population and stakeholders: The primary focus of this study is on the perspective of Youth Care professionals and parents in the renewed Dutch Youth Care system. The study is funded by ZonMw, The Netherlands Organisation for Health Research and Development and is executed by researchers in collaboration with Youth Care professionals, parent representatives, policy makers and educational institutions. Timeline and Highlights: This practice-based action research is performed during a 4 year period (2016-2019). By providing continuous feedback based on the results of the study, professionals and other stakeholders are stimulated to learn and improve the quality of care. Sustainability and Transferability: The relevance, impact and transferability of the current research is augmented by continuously involving representatives of Youth Care professionals and their management, policy makers, parents and youth, and representatives from the educational field during all phases of the project. In order to obtain comprehensive and representative conclusions, results are examined by triangulation and member checks, facilitating the implementation of these results in practice. Conclusion, Discussion and Lessons Learned: Several facilitators and barriers are identified from the qualitative data. Providing direct feedback to professionals stimulates a learning process and encourages professionals to improve quality of care. To maintain stakeholders’ active involvement, it is crucial to involve them as fellow researchers, operate transparent and provide frequent updates about the progress of the project.

Residential youth care settings should provide youth with safe environments where they are supported and treated. However, there are aspects of residential youth care that threaten its effectiveness, and which may also violate children’s rights. Staff members exercise power over the youth, which can be abused to coerce, punish, or limit the autonomy of youth. Currently, the harmful behavior of staff includes repression through such acts as harsh and unfair control, punishment, and lack of autonomy granting. However, research on the exact nature of repression is lacking, which hampers empirical research on repression in residential youth care, and makes it difficult for residential settings to recognize repression and take the right corrective measures. A scoping review of the available literature is conducted from a humanistic, social psychological, and organizational perspective to examine the nature of repression and to provide a valid definition and its antecedents. This article offers implications for preventing, recognizing, and diminishing repression in residential youth care.

When risky child and family circumstances cannot be resolved at home, (temporary) 24-h out-of-home placement of the child may be an alternative strategy. To identify specific placement risks and needs, care professionals must have information about the child and his or her family, care history, and social-cultural characteristics at admission to out-of-home care. However, to date information on case characteristics and particular their similarities and differences across the three main types of out-of-home settings (namely foster care, family-style group care, and residential care) is largely lacking. This review compiles and compares characteristics of school-aged children of average intelligence and their families at the time of each child’s admission to one of the three care modalities. A scoping review technique that provides a broad search strategy and ensures sufficient coverage of the available literature is used. Based on the 36 studies included, there is consensus that the majority of normally intelligent children in care demonstrate severe developmental and behavioral problems. However, the severeness as well as the kinds of defining characteristics present differ among the children in foster care, family-style group care, and residential care. The review also identifies several existing knowledge gaps regarding relevant risk factors. Future research is recommended to fill these gaps and determine the developmental pathway in relation to children’s risks and needs at admission. This will contribute to the development of an evidence-based risks and needs assessment tool that will enable care professionals to make informed referrals to a specific type of out-of-home care when such a placement is required.

Objective This multilevel meta-analysis compared the outcomes of Treatment Foster Care Oregon for Adolescents (TFCO-A) and home-based treatment programs (HBT) with residential youth care for children and youth aged 0 to 23 years. Methods A total of 145 effect sizes for different types of behavioral problems were derived from 24 controlled studies (n = 16,943 participants). A three-level random-effects meta-analysis was conducted. Results We found a small statistically significant overall effect (d = 0.21), 95% CI [0.090-0.338], which indicated that non-residential youth care was slightly more effective than residential youth care. However, moderator analysis revealed that TFCO-A yielded a larger effect size (d = 0.36) than HBT (d = 0.08). Conclusions Our findings suggest that youth treated in treatment foster care have better outcomes than youth in residential care, which is not true for children who are treated at home. Therefore, in case of out-of-home placement treatment foster care should be the first option. Given that residential care has no additional value for youth who are treated at home, and often sets limits to juveniles’ needs for self-determination, residential care seems an option if TFCO-A is not available and living at home is no longer possible because the child’s (immediate) safety is at stake.

In this retrospective longitudinal study we examined which characteristics of 114 Dutch adolescents, aged 12–18 years, and their environment, predicted (un)successful completion of a non-residential alternative educational program for adolescents with complex problems, who are at risk for school drop-out or residential placement. The adolescents received care and education in a non-residential alternative educational facility (School2Care) for a mean period of 9.6 months (SD = 5.5 months). 69% successfully completed the program, and 31% unsuccessfully completed the program, ending in residential placement or living at home without school attendance, work or internship. Case file analyses showed that younger age, disruptive behavior disorder and one-parent families predicted unsuccessful program completion. It should therefore be examined whether the alternative educational program can be improved to better meet the needs of younger adolescents, adolescents with disruptive behavior disorder, and from one-parent families.

The study consisted of a comparative follow-up study with a pretest-posttest design which explored the association between baseline child, family, and care characteristics and the psychosocial development of 121 school-aged Dutch children (M age = 8.78 years; SD = 2.34 years; 47% female; 59% Caucasian) during their first year of placement in foster care (FC), family-style group care (FGC), and residential care (RC). Potential baseline characteristics were collected from both literature data and pretest data, and measured with standardized questionnaires and case file information. The outcome measure (degree of psychosocial development) was based on pretest and posttest ASEBA measurements of substitute caregivers, by calculating the reliable change index (RCI). Based on this, 58% of the children had favorable psychosocial development, with no significant differences across the settings. Results indicated that sets of baseline characteristics were able to distinguish different groups of favorably developing children as well as unfavorably developing children in different settings, whereby unfavorable development could be estimated more accurately. A history of maltreatment proved to be an important risk factor, particularly for family-based settings (FC, FGC). Furthermore, results indicated that specialized treatment is needed for severe individual problems in children in FGC, as these problems were associated with unfavorable psychosocial development for them in particular. With regard to residentially placed children, child mental illness specifically negatively affected their prognosis. Further research is needed to refine the results in order to make them suitable for both supporting decision-making processes and monitoring out-of-home placements.

Purpose– Violence is a common problem in secure residential units for young people. Group workers often think that young people have to learn to behave by means of punishment. The purpose of this paper is to investigate whether this approach is effective in these settings, and, if so, under what circumstances. Furthermore, it aims to provide alternatives to punishment when dealing with violence.Design/methodology/approach– Recent evidence on the effectiveness of punishment in secure residential units is reviewed. In addition, methods which are promising in dealing with violence are described.Findings– The review shows that punishment is often used to regain control by group workers or, alternatively, is a result of professional helplessness in the face of escalating problems. Only when the living group climate is marked by trust and cooperation can punishment be effective.Originality/value– Punishment in secure residential settings can have severe negative consequences. Nevertheless, group workers are tempted to use it as a response to violence in an attempt to gain control.

The aim of this study was to compare results of and develop guidelines for mandatory allocation of sexually transgressive juveniles to Multisystemic Therapy - Problem Sexual Behavior (MST-PSB), Secure Youth Care (SYC), or Forensic Youth Care (FYC), based on the risk-need-responsivity model. Results of current allocation showed a population with relatively less treatment needs to receive community-based MST-PSB, compared with populations receiving residential SYC and FYC. Furthermore, estimated recidivism risk levels did not always support the need for risk reduction by the imposition of limitation of freedom of movement and maximum supervision, provided by all three treatment modalities. Based on the assessed sexual recidivism risk, 38% of the juveniles in FYC, 7% in SYC, and 24% in MST-PSB received treatment that was too intensive, which is considered detrimental to motivation and development. Future allocation practices could benefit from assessing treatment needs and recidivism risk, by use of an actuarial tool.

Live metaphor embraces living thought, developing consciousness and emergent awareness. Mundane literalness achieves none of these. We have applied Ricoeur's theory of ‘live metaphor’ (P. Ricoeur. 1975. La Metaphore vive. Paris: Seuil (Translated 1978 as: The rule of metaphor. Toronto: University of Toronto Press; London: Routledge)) to story-telling research in an effort to reveal the continuum between work-place stories and metaphors. The story collecting was intended to illustrate ‘voice’ and ‘hardiness’ and to act as a tool for organizational change. But, in hindsight, the data better matched Derrida's metaphor of the disappearance or death of the postcard (J. Derrida. 1987. The postcard. Chicago: University of Chicago Press), which emphasizes the complexity and fragility of trying to link researchers and researched, self and other. With Ricoeur, we conclude that metaphor is what carries meaning from the one to the other.

One of the aims of the ICF is to provide a scientific basis for consequences of health conditions. However, the ICF does not include a list of personal factors, as no international consensus could be achieved on the structure of such a list. This leads to many broad and disparate poorly defined variables. For the ergonomics consultant the term occupational style appears to be a promising umbrella construct.Results from recent research have increased the popularity of the construct ‘work style’, in several disciplines. Work style is related to the ‘old’ construct of occupational style. In this article, we plea for the revival of occupational style which implies focussed attention to further develop the theoretical construct and its practical implications for research, assessment, and treatment/ intervention for occupational therapists working as ergonomic consultants.

Voor het implementeren van evidence-based practice (EBP) in het fysiotherapeutisch handelen is een gedragsverandering nodig. Omdat veranderingen in het beroepsmatig handelen tijd en aandacht kosten, worden in dit artikel verschillende fases in gedragsverandering onderscheiden. Om EBP effectief en efficient te implementeren in het fysiotherapeutisch handelen, is een model beschreven waarbij strategieen voor het implementeren van EBP gekoppeld worden aan (mogelijke) obstakels en fases van gedragsverandering.

The Assessment of Daily Activity Performance (ADAP) test has been developed to measure the physical capacity of older adults to carry out instrumental activities of daily living (ADL). The present study explores the option to create a less time-consuming short version of the ADAP that can be completed in the individual’s home environment and that imposes less of a physical burden. Data from 141 independently living women aged 70 and older were analyzed using principal components analysis (PCA). PCA identified two factors, on which 10 of the original 21 items had loaded sufficiently to be eligible for inclusion in a short version. The ADAP short version is considerably shorter than the original test and provides a good representation of the constructs being measured. More research is necessary to develop a short version of the ADAP that is easily applicable in the home environment of older adults.

Reply Reply This contribution is a reply on the article ‘De waarde van kwalitatieve strategieën voor het praktijkgericht onderzoek’, written by Piet J.M. Verschuren. Using the concepts of framing, indolence, dialogue and polyphonic causality Kuiper and Houweling aim at enriching the discourse of causality perceptions in qualitative research presented by Verschuren.

Ruim een jaar geleden zagen wij een aankondiging voor een cursus Q-methodologie. Geprikkeld door de enthousiaste verhalen van AnneLoes en Susan schreven we ons in. Het leek ons de ultieme test. Twee (relatieve) tegenpolen in de collegezaal: een voornamelijk kwantitatief onderzoeker zij aan zij met de kwalitatieve onderzoeker bij de cursus Q-methodologie. Even fraai kan het worden samen tweestemmig een reactie te schrijven op het artikel van dezelfde AnneLoes en Susan.

Jeugdigen met autismeproblematiek hebben moeite met het aanpassen aan nieuwe situaties. De overgang naar het (speciaal) voortgezet onderwijs kan voor deze jeugdigen een uitdaging vormen. Het is daarom van belang dat op de basisschool programma’s worden ingezet die ertoe bijdragen dat deze leerlingen goed voorbereid de overstap kunnen maken.