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Item does not contain fulltext, In the last decade, living groups in residential youth care facilities in The Netherlands have gradually grown in size with eight to twelve adolescents per group, which is related to an increase in workload and overburdened personnel. Research suggests that a smaller group size of up to six adolescents can have a positive impact on the living and working environment, and therefore small-scale facilities are advocated as a an alternative for regular residential youth care. Little is known about the experiences of residential care personnel working in these small-scale facilities. The aim of this study is to examine the impact of the transformation toward small-scale facilities from the perspective of residential care personnel. The results show, in line with previous studies, that professionals working in small-scale facilities experience a safer and more positive group climate and that they are more able to invest in a positive therapeutic relationship with the adolescents, than working on regular residential groups. Moreover, working on a group with fewer adolescents affects the working climate in a positive way. Recommendations for practice and further research are proposed., 19 p.

Item does not contain fulltext, In the past decades, awareness of the harmful effects of seclusion has led to a strong desire to reduce its use in child and adolescent residential care settings. As a response, various seclusion reduction interventions have been developed and implemented in practice. These interventions consist of both methods as well as more practice-based and ad hoc actions. Identification of common elements within this wide variety of seclusion reduction interventions would be beneficial for the further understanding and implementation of these interventions, training of staff, and research aimed at the reduction of seclusion. Therefore, the objective of this study was to identify the common elements of both methods and practice-based actions to reduce seclusion in child and adolescent residential care settings. A literature review and semi-structured interviews with experienced professionals involved in child and adolescent residential care were used to determine the common elements of seclusion reduction interventions. In total, 21 studies and 11 interviews were assessed. This led to the identification of two domains with six common elements each. Further investigation of how these common elements influence the reduction of seclusion could potentially build strong universal methods and training modules for the reduction of seclusion in a broad range of child and adolescent residential care settings., 12 p.

10 augustus 2022, Contains fulltext : 252906.pdf (Publisher’s version ) (Open Access), Seclusion can be harmful for children and adolescents. Hence, all locations for secure residential youth care in the Netherlands are committed to reduce its use by implementing monitoring and feedback as a seclusion reduction intervention. This study examined change over time in the use of seclusion in secure residential youth care in the Netherlands using a broad conceptualization of seclusion and by analyzing four variables (frequency, duration, room, reason). During two six months periods, seclusions were registered in 19 locations. Every month, all locations received feedback on the use of seclusion. Negative binomial mixed model analyses were used to investigate change over time in frequency and duration of seclusion. Logistic mixed model analyses were used to identify change over time in reason for use and type of room used for seclusion. Results showed that seclusion frequency significantly decreased (RR = 0.92, p < .001). Further, duration of placement in a seclusion room significantly increased (RR = 1.04, p < .001). This change was only significant in seclusion in response to aggression (RR = 1.06, p < .001). The results emphasize the need for future studies to examine reduction using a broad conceptualization of seclusion.

Item does not contain fulltext, Using seclusion in youth mental health care is controversial, as it can have physical and psychological consequences for youth and professionals. Notably, there is a wide disparity in how seclusion is defined in literature and practice. This leads to a diffuse image of what seclusion comprises, complicates measuring its prevalence, and hampers initiatives to reduce its use. Therefore, the objective of this study was to establish an unambiguous and measurable definition of seclusion supported by youth and professionals in secure residential youth care in the Netherlands. A qualitative multiphase approach was used to examine which elements of the definition are essential and receive consensus among youth and professionals. After a brief literature review, a Delphi survey and focus groups were performed. In total, 11 (ex-)clients and 33 professionals with extensive experience in secure residential youth care participated. Youth and professionals arrived at the following definition: ?an involuntary placement in a room or area the client is not allowed or able to leave? During the implementation process, observations showed broad support for the definition by youth and professionals. With this, a foundation has been provided to monitor and reduce the use of seclusion in secure residential youth care in the Netherlands.

Background: Adolescents in residential care are a vulnerable population with many problems in several life areas. For most of these adolescents, these problems persist after discharge and into adulthood. Since an accumulation of risk factors in multiple domains increases the likelihood of future adverse outcomes, it would be valuable to investigate whether there are differences in life after residential care between subgroups based on multiple co-occurring risk factors. Aims and hypothesis: The aim of this exploratory follow-up study is to explore differences between young adults—classified in four risk profiles—in relation to life after discharge from a secure residential care setting. It is hypothesised that young adults with a profile with many risks in multiple domains will experience more problems after discharge, such as (persistent) delinquency, compared to young adults with a profile with lower risks. Methods Follow-up data were collected from 46 former patients of a hospital for youth forensic psychiatry and orthopsychiatry in the Netherlands. In order to illustrate these young adults’ life after discharge, self-reported outcome measures divided into five domains (i.e., quality of life, daily life, social life, problems, and delinquency) were used. Differences between four classes based on pre-admission risk factors, which were identified in a previous study by latent class analysis, were explored by three (non-)parametric statistical tests. Results: Life after discharge for most young adults was characterised by close friends and a high quality of life, but also by substance abuse, professional support, debts, and delinquency. Only a few significant differences between the classes were found, primarily between young adults with risk factors in the individual, family, school, and peer domains and young adults in the other three classes. Conclusions: Young adults experience a high quality of life after

The development of delinquent behaviour is largely determined by the presence of (multiple) risk factors. It is essential to focus on the patterns of co-occurring risk factors in different subgroups in order to better understand disruptive behaviour. The aim of this study was to examine whether subgroups could be identified to obtain more insight into the patterns of co-occurring risk factors in a population of adolescents in residential care. Based on the results of prior studies, at least one subgroup with many risk factors in multiple domains and one subgroup with primarily risk factors in a single domain were expected. The structured assessment of violence risk in youth and the juvenile forensic profile were used to operationalize eleven risk factors in four domains: individual, family, peer and school. Data from 270 male adolescents admitted to a hospital for youth forensic psychiatry and orthopsychiatry in the Netherlands were available. Latent class analysis was used to identify subgroups and significant differences between the subgroups were examined in more detail. Based on the fit statistics and the clinical interpretability, the four-class model was chosen. The four classes had different patterns of co-occurring risk factors, and differed in the included external variables such as psychopathology and criminal behaviour. Two groups were found with many risk factors in multiple domains and two groups with fewer (but still several) risk factors in single domains. This study shed light on the complexity of disruptive behaviour, providing a better insight into the patterns of co-occurring risk factors in a heterogeneous population of adolescents with major psychiatric problems admitted to residential care.

In the Netherlands, the top 5% most serious juvenile off enders are placed in juvenile justice institutions under a mandatory treatment order. After two to six years of treatment, the chance of recidivism is supposed to have been reduced considerably. The new off enses that do take place, are supposed to be less severe in nature than the off enses that were committed before treatment. Over the years, several interventions aimed at these serious off enders have been developed. However, the eff ectiveness of most interventions has not been demonstrated yet. Specialists in the fi eld have said for years that improvement of interventions is needed. However, until now little research has been done on risk factors that predict recidivism in this group of very serious off enders. This is important because of the risk of this subgroup for society, for the victims and for the juveniles themselves. If more is known about the precursors of serious juvenile off ending and recidivism, existing interventions may be improved, new interventions may be developed and the eff ectiveness of interventions may be higher. However, the accuracy of current ways of predicting off ending and future recidivism is still far from perfect with eff ect sizes that are seldom higher than 0.70 (Hanson & Morton-Bourgon, 2009). Thus new ways to come to evidence-based decision making and the development of evidence-based interventions need to be explored.