Ignace P.R. Vermaes

Study protocol: a randomised controlled trial testing the effectiveness of 'Op Volle Kracht' in Dutch residential care

BackgroundAlthough adolescents are often referred to residential treatment centres because of severe externalizing behaviours, a vast majority demonstrated comorbid symptoms of depression and anxiety. Covert internalizing symptoms in these adolescents might be easily unrecognized and therefore untreated. Adolescents with mild intellectual disability (MID) are overrepresented among youth with both externalizing and internalizing problems. There are yet few treatment programs available for adolescents with both externalizing and internalizing problems.Methods/designThe CBT-based resiliency program, Op Volle Kracht (OVK), which is based on the US Penn Resiliency Program (PRP), was adapted to suit the needs of adolescents with both externalizing and internalizing problems, either with or without MID, in Dutch residential treatment centres. The effectiveness of this group intervention program of eight sessions will be tested in a randomised controlled trial (RCT) with N = 182 adolescents aged 12–16, allocated to either the target intervention plus treatment as usual (OVK + TAU) or treatment as usual only (TAU). The main outcome variables include depressive symptoms (primary), anxiety, behavioural problems, and group therapeutic climate. Cognitive styles and coping styles will be included as possible mediators. Assessments take place at baseline (T1), one week before the start of the program (T2), immediately after the program (T3), and at three months follow-up (T4).DiscussionThe program assets include its wide implementation possibilities due to low costs, the short duration of the program and the delivery by group care workers, and its suitability for adolescents with MID. Further strengths of the present study design include its robust method (RCT), the ecological validity, and the inclusion of possible mediators of treatment effect. The program emphasizes individual risk factors for depression rather than social and family factors. Implications for practice and future research are discussed.Trial registrationDutch Trial Register NTR4836

Who Wants to Participate in Routine Outcome Monitoring? Differences between Youth in Secured Residential Care Who Consent or Refuse the Use of Their Clinical Data for Research and Policy Making

ABSTRACT This study examines the external validity of a nationwide dataset, considering the fact that clients can refuse the extraction of their clinical information to aggregate datasets. Data of 949 youths (56% boys, mean age 15.6 years, SD = 1.49) from six Dutch residential institutions were included. An individual-variables and a person-oriented approach were applied to examine the extent to which the group giving permission to the use of their data for aggregate purposes (66%) is representative for the total population in secure residential youth care. Both static, non-changeable client information as well as dynamic, changeable client information were gathered. Youths who assented to the use of their information were overrepresented amongst the population of some of the participating institutions, and were more often Caucasian. Three start profiles based on the dynamic variables were distinguished. Youths who assent were overrepresented in the most problematic profile, whereas youth who did not assent were overrepresented in the least problematic profile. To improve the external validity and the value of the monitor, it is important to achieve more uniformity between institutions as far as the procedures are concerned, and to find creative ways to increase the assent levels, particularly among ethnic minorities.