Annemiek Harder

Therapeutic residential care for children and youth: a consensus statement of the International Work Group on Therapeutic Residential Care

While the focus of this consensus statement and the review volume that preceded it (Whittaker, Del Valle, & Holmes, 2014) is on therapeutic residential care (TRC), a specialized form of group care, we view our work as supportive of a much wider effort internationally concerned with the quality of care children receive when, for a variety of reasons, they need to live away from their families.

Securing the Downside Up: Client and Care Factors Associated with Outcomes of Secure Residential Youth Care

BackgroundAlthough 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.ObjectiveThe objective of the present study was to explore the association of these potential success factors with secure residential care outcomes.MethodsA 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.ResultsAdolescents 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.ConclusionsThe 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.

Risky or Needy? Dynamic Risk Factors and Delinquent Behavior of Adolescents in Secure Residential Youth Care

Although it is known that adolescents in secure residential care often show multiple behavior problems, it is largely unknown which dynamic risk factors are associated with their problems. The aim of the present study is to examine dynamic risk factors for 164 Dutch adolescents in secure residential care. Results show that a majority reports multiple risk factors in both an individual and contextual domain but that about a fifth shows relatively few risk factors. Substance abuse and delinquent friends were among the five most prevalent risk factors and predicted the seriousness of the adolescents’ delinquent behavior prior to admission. The four groups that were found by cluster analysis could be distinguished by problem type and seriousness. The findings indicate that treatment for some adolescents should be mainly focused on their individual needs, while other adolescents need intensive, multimodal treatment focusing on both risks in the individual, family, and peer domains.

Different sizes, similar challenges: out of home care for youth in Germany and the Netherlands

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.

Participation of youth in decision‐making procedures during residential care: A narrative review

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.

Space between the borders? Perceptions of professionals on the participation in decision-making of young people in coercive care

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.

The Inside Out? Views of Young People, Parents, and Professionals Regarding Successful Secure Residential Care

Although adolescents often seem to improve in their functioning during residential care, there still is little knowledge on what factors are important in achieving these changes. The present study aims to identify the care factors that are important for adolescents’ behavior change during secure residential care. We conducted in-depth interviews with eight adolescents, their parents, eight group care workers and seven teachers concerning their in-care experiences. Both adolescents and parents commonly attributed changes during secure residential care to the treatment environment. Group care workers and teachers did not have a clear, consistent view on the treatment aspects causing positive change with the adolescents. According to the adolescents, good professionals apply a fine balance between rules and freedom, show empathy and are available for support. The view of parents corresponds to this image. Although group care workers are perceived as available for support, adolescents tend to make little use of this help if they experience personal problems during care. The results highlight the importance of responsiveness of secure residential care professionals to the needs and perspectives of adolescents and parents.

Acogimiento residencial terapéutico para niños y adolescentes : una declaración de consenso del grupo de trabajo Internacional Sobre Acogimiento Residencial Terapéutico

Therapeutic Residential Care for Children and Youth: A Consensus Statement of the International Work Group on Therapeutic Residential Care. In many developed countries around the world residential care interventions for children and adolescents have come under increasing scrutiny. Against this background an international summit was organised in England (spring 2016) with experts from 13 countries to reflect on therapeutic residential care (TRC). The following working definition of TRC was leading: “Therapeutic residential care involves the planful use of a purposefully constructed, multi-dimensional living environment designed to enhance or provide treatment, education, socialization, support, and protection to children and youth with identified mental health or behavioral needs in partnership with their families and in collaboration with a full spectrum of community based formal and informal helping resources”. The meeting was characterised by exchange of information and evidence, and by preparing an international research agenda. In addition, the outlines of a consensus statement on TRC were discussed. This statement, originally published in English and now reproduced in a Spanish translation, comprises inter alia five basic principles of care that according to the Work Group on Therapeutic Residental Care should be guiding for residential youth care provided at any time.

Pedagogische kwaliteiten van voorzieningen voor residentiële jeugdzorg

Onder de jeugdigen die worden opgenomen in residentiele hulpvormen is de afgelopen decennia het aantal kinderen en jongeren met ernstige problematiek relatief toegenomen. Zowel in Nederland als in Europa is er sprake van een grotere complexiteit en een langere duur van de aanwezige problematiek (Colton & Hellinckx, 1994). Met behulp van residentiele zorgprogrammas wordt geprobeerd om de ernstige gedrags- en opvoedingsproblemen bij deze groep te verminderen en de kwaliteit van bestaan van de jeugdigen te vergroten.

2.345 Jeugdigen (z)onder dak: Een meta-analyse naar de uitkomsten van residentiële jeugdzorg

SamenvattingIn dit overzichtsartikel doen we verslag van onderzoek naar de uitkomsten van residentiële jeugdzorg. Op basis van strenge inclusie- en selectiecriteria vonden we 27 pre- en quasi-experimentele studies (PE en QE) naar de uitkomsten van residentiële behandeling bij 2.345 kinderen en jongeren. Aangezien er verschillen zijn in de toegepaste uitkomstmaten, geven we een integraal overzicht van alle individuele effectgrootten in de studies. Voor zeven studies met een PE-design was het echter mogelijk om een totale effectgrootte te berekenen. Hierbij varieerden de gewogen gemiddelde effectgrootten van .45 (geïnternaliseerd probleemgedrag) tot .60 (externaliserend probleemgedrag; gedragsproblemen in het algemeen). QE-studies laten zien dat residentiële progamma’s waarbij gedragstherapeutische en gezinsgerichte methoden worden toegepast, de meest veelbelovende uitkomsten op korte termijn opleveren. De studies leveren weinig informatie over de uitkomsten van residentiële jeugdzorg op de lange termijn. Tevens valt op dat in veel onderzoek een specifieke beschrijving van het residentiële behandelprogramma ontbreekt.SummariesHarder, A. T., & Knorth, E. J. (2009). 2.345 Youth with(out) a roof over their head: A review and selective meta-analysis of the outcomes of residential child and youth care. Kind en Adolescent, 30 (4), 210-230We report in this review on research into outcome studies of residential child and youth care. The application of strict inclusion and selection criteria yielded 27 pre- and quasi-experimental studies (pe and qe) that examined the outcomes of residential treatment for 2.345 children and adolescents. Since there is variation in the outcome measures, we give an integral overview of all the individual effect sizes (es’s) in the studies. However, it was possible for seven studies with a pe design to calculate an overall es: the weighted mean effect sizes ranged from .45 (internalized problem behaviour) to .60 (externalizing problem behaviour; behaviour problems in general). qe studies prove that residential programmes applying behaviourtherapeutic methods and focusing on family involvement show the most promising shortterm outcomes. There is little evidence about the long-term outcomes of residential care. It is also striking that many studies lack a specific description of the residential intervention programme.