Secure Residential Research Articles

Team Functioning in Secure Residential Care Facilities: Validation of a Self-Report Measure

ABSTRACT Secure residential care with clients with severe behavioral and psychiatric problems, team functioning is important for safety. Therefore monitoring team functioning on a regular basis can help in improving safety and care quality. The present study examined the construct and concurrent validity of a parsimonious staff self-report measure, the Pantrix. Results in a sample of 1.137 workers indicated that a two-factor model (positive and negative team functioning), consisting of 17 items showed a good fit to the data, indicating construct validity of the measure. Findings indicate that the instrument may be used as a parsimonious valid and reliable monitoring instrument.

Living Situation of Juveniles After Secure Residential Treatment: Exploring the Role of Family Centeredness, Child, and Family Factors.

To promote the return of juveniles to a home-like environment (e.g. living with (foster)parents) after secure residential treatment (SRT), it is important to know which factors are related to this outcome. The current study examined which characteristics of the juvenile, family, and SRT, including family centeredness and use of systemic interventions, are related to the living situation after discharge. For 259 juveniles (mean age 15.82 years, 127 girls) in SRT and their parents, questionnaires were administered at admission, discharge, and 6-months follow-up. Furthermore, information about the living situation before and after SRT was gathered. Higher likelihood of living in a home-like setting after SRT correlated with more furlough moments with parents, receiving a systemic intervention, and a shorter duration of the SRT. Systemic interventions during SRT and spending furlough moments with parents may have a positive impact on returning to a home-like situation after SRT for juveniles.

Family-Centeredness in Secure Residential Treatment and Its Relationship With Parental Involvement and Adolescent Behavioural Outcomes

Various Dutch secure residential youth care (SRYC) institutions are implementing a family-centered approach aiming to increase parental involvement and improve treatment outcomes. However, it remains unclear if and how family-centeredness (FC) is related to increased parental involvement and to improved treatment outcomes of adolescents. In this study, we unravelled the relation between FC, parental involvement, and behaviour problems of adolescents in SRYC. Families of 404 adolescents admitted to one of seven participating Dutch SRYC institutions completed a survey (at the start, at the end, and at 6-months follow-up) on problem behaviour of adolescents. In addition, 411 group care workers filled out a questionnaire about their residential group’s level of FC every 6 months. Moreover, the mentor of each adolescent filled out a questionnaire about the level of parental involvement. We analysed the data using multiple mediator models. Associations were found between FC and parental involvement. However, no relation was found between FC and adolescent problem behaviour, and no mediation and no moderation effects of parental involvement were found. Overall, results showed that most parents were involved during the residential stay, and, independent of FC, adolescent problem behaviour decreased over time. Implementing FC in SRYC institutions seems to be helpful in involving parents during the residential stay, but was not found to be associated with adolescent behavioural outcomes. Our results indicate that institutions could improve their level of FC by offering more informal contact moments for parents and by addressing barriers to FC among residential staff.

How do group workers respond to suicidal behavior? Experiences and perceptions of suicidal female adolescents residing in secure residential youth care in the Netherlands.

Adolescent suicidal behavior, including non-suicidal self-injury, is increasingly prevalent in Secure Residential Youth Care (SRYC) in the Netherlands. Group workers play a vital role in the well-being and functioning of adolescents in SRYC as they interact with adolescents on a daily basis. However, we have little understanding of how adolescents perceive group workers' responses to suicidal behavior and we lack knowledge about the impact of these responses on adolescents and the group climate. The aim of this study is to explore (a) how adolescents value group workers responses towards suicidal behavior and (b) the impact of these responses on adolescents, as well as (c) on the group climate. The results can be used to develop care-policy to improve care for suicidal adolescents in SYRC. Eleven suicidal female adolescents residing in SRYC were interviewed. All adolescents had previously displayed suicidal behavior, including non-suicidal self-injury. Interviews were analyzed using grounded theory. This study presents the perceptions of suicidal female adolescents residing in SRYC about group workers' responses on suicidal behavior. Adolescents prefer group workers who react responsive to suicidal behavior. Responsive care, trust and connectedness help adolescents disclose their suicidal thoughts. Participants criticize group workers who are non-responsive as being distant, and their relationship with these group workers lacked trust, communication, a sense of connection, or personal depth. All adolescents underline the devastating impact of involuntary seclusion, and stress the importance of being able to disclose without fear of coercive consequences. Findings indicate that non-responsive reactions contribute to an increase in suicidal distress as well as a closed group climate.

The Sanctuary Model: A Trauma-Responsive Environmental Model for Secure Residential Facilities Within the Juvenile Justice System

Exposure to trauma is considered a critical factor in explaining the onset and maintenance of youth aggression. Integrating trauma-responsive practices into the operations of youth-serving systems improves incarcerated youths’ adaptive functioning and ability to succeed when back in society and serves as an opportunity to reduce the likelihood of future aggression. The Sanctuary Model is an approach to organizational culture change based on the structural development of processes that facilitate trauma-responsiveness within a therapeutic community environment. The Colorado Division of Youth Services adopted the Sanctuary Model as part of the primary foundational organizational model of care in 2014. This conceptual article first describes the Sanctuary Model and discusses its implementation using Bowen and Murshid’s (2016) social justice and trauma-informed social policy framework. The article provides an analysis that leads to seven recommendations that will assist organizational leaders in justifying the model at every stage of implementation, including the ongoing sustainability of the practices.

Associations between Secure Residential Care and Positive Behavioral Change in Adolescent Boys and Girls

ABSTRACT 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.

Children’s Rights in Secure Residential Youth Care in the Netherlands

Abstract This study examines the extent to which secure residential youth care in the Netherlands complies with children’s rights as laid down in the United Nations Convention on the Rights of the Child (uncrc) and the Dutch Youth Act. Residential group climate was measured with the Prison Group Climate Instrument (pgci), which assesses quality of group care from the perspective of the three basic needs for human self-determination: contact, autonomy and competence. Results indicate that children’s rights are a subsidiary issue in secure residential youth care in The Netherlands, because groups workers and staff have insufficient understanding of children’s rights and Dutch legislation on youth care. Dutch law allows secure facilities to make their own policy on youth care delivery, but it seems that policies are insufficiently explicit about children’s rights. Results of this study can be used to work on the fulfilment of children’s rights in secure residential youth care.

Defining Seclusion: A Qualitative Multiphase Study Based on the Perspectives of Youth and Professionals in Secure Residential Youth Care in the Netherlands

ABSTRACT 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.

A Schema Therapy Based Milieu in Secure Residential Youth Care:Effects on Aggression, Group Climate, Repressive Staff Interventions, and Team Functioning

ABSTRACT Group care workers of residential youth care settings face the challenge of creating a warm and involved treatment climate against the demands and restrictions of the treatment setting. We tested the effects of SafePath, a milieu-based intervention based on Schema Therapy principles, during the first year of implementation on two secure residential treatment units compared to two control units. Staff’s daily reports on 139 individual patients were coded on use of schema mode language (implementation check), occurrences of aggression (primary outcome) and repressive staff interventions. In addition, repeated questionnaires were filled out by patients (n = 87) on group climate and by staff (n = 50) on team functioning. Compared to the control units, SafePath units showed higher improvements in group climate and repressive interventions. Both SafePath and control units showed decreased aggression over time. Team functioning was consistently better in the SafePath units compared to the care-as-usual units from baseline through 12 months. In conclusion, a Schema Therapy based milieu as implemented with SafePath may contribute to a warm and supportive group climate with less repressive interventions in secure residential youth care.

Treatment Outcomes of a Shortened Secure Residential Stay Combined With Multisystemic Therapy: A Pilot Study.

ThuisBest is a newly developed family focused treatment that combines secure residential youth care with multisystemic therapy (MST), allowing adolescents to return home after secure residential youth care more quickly. The purpose of this pilot study was to examine treatment outcomes for adolescents in ThuisBest (n = 86, Mage = 15.2 years, 63% boys) and to what degree those treatment outcomes could be predicted by client characteristics. The results showed that externalizing behavior problems and parenting stress had decreased at the end of treatment. After ThuisBest, 83% of the adolescents did not have new police contact, 72% lived at home, and 89% attended school or work. Almost none of the treatment outcomes could be predicted by any of the client characteristics. ThuisBest seems a promising trajectory, as it reduces the length of the stay in secure residential youth care, and may, therefore, be more cost-effective than standard secure residential youth care. However, given the lack of a control-group and follow-up data, findings must be interpreted as preliminary.

My Path Towards Living on My Own: Voices of Youth Leaving Dutch Secure Residential Care

Youth departing from secure youth care are often not well prepared for living on their own. This study aims to provide more insight into youth’s perspectives on what they need to improve their chances for successful return to and participation in Dutch society. The study is a first necessary step on a journey to develop a tool for these youth to evaluate the development of autonomy and participation. We chose for a participatory research methodology. Youth participated as co-researchers in all steps of the research. Sixteen adolescents aged 15–20 years participated in open in-depth interviews using an autobiographical life story method. They were treated as partners and future owners of the tool to be developed. The interviews were transcribed and analysed. Realizing trustworthy social bonds appeared essential for developing autonomy. Youth started to move when they were socially connected and had found out what they value. Then they started “to do their thing” and “to find their own path”, which was their language for experiencing autonomy. An interesting new finding was the importance of rest for youth to enable them to develop self-insight and to find their own path. The findings imply that staff in secure residential care should invite youth to develop their own ideas about their life and future, stimulate exploration and reflection, and a dialogue with people around them. Opportunity for acting, trying and doing is also needed, so that youth can discover in practice what works for them.

Perceived Living Conditions of Young People in Secure Residential Care: Psychometric Properties of the Best Interest of the Child \u2212 Self-Report Questionnaire (BIC-S)

The Best Interest of the Child − Self-report questionnaire (BIC-S) is designed as a tool to ensure young people in secure residential care have a voice about their living environment. The primary aim of this study was to determine the psychometric properties of the BIC-S. Second, we wanted to map the experiences of young people with their current residential living environment. Therefore, both quantitative and qualitative methods were used to assess the experiences of young people with the BIC-S instrument in this cross-sectional study. Based on a sample of 74 young people staying in secure residential care in the Netherlands (2015), we explored the construct validity and reliability of the BIC-S through a Mokken Scale Analysis. The sample consisted of 38 boys and 36 girls (mean age 15.5). After evaluating the psychometric properties of the instrument, we focused on the experiences of young people with their current residential living environment. The results show that eleven out of the fourteen BIC-S conditions form a moderate scale to measure how young people perceive the quality of their living environment (H = .40; Rho = .86). With regard to the residential environment, the participants often raise issues which relate to personal safety, to activities within the institute, or to the relationship they have with care professionals. The results indicate that the BIC-S has the potential to serve as an instrument for young people to voice opinions on their living environment while in residential care.

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.

Multi-Tiered Systems of Support Within Secure Residential Juvenile Facilities

With approximately 60,000 youth in secure residential juvenile facilities in the United States on any given day (U.S. Department of Education, 2014), it is paramount that their diverse and complex ...

Youth Voice Matters: Perceptions of Facility-Wide PBIS Implementation in Secure Residential Juvenile Facilities

The implementation of the positive behavior interventions and supports (PBIS) framework within secure juvenile facilities is on the rise; however, there is minimal research regarding stakeholder views of PBIS, especially from the youth perspective, within these facilities. This article provides a summary of focus groups conducted across eight secure juvenile facilities in which PBIS was implemented and youth perspective was assessed. Focus groups were conducted with 3–5 youth from each facility using a standard set of questions to determine youth views of PBIS. The authors present themes identified using the constant comparative method in relation to facilitators and barriers to PBIS implementation. In addition, findings are discussed in relation to high-, mid-, and low-performing facilities in relation to fidelity of implementation; as well as youth suggestions for improving PBIS. Limitations as well as future directions are discussed.

Safety in numbers: group therapy-based index offence work in secure psychiatric care

In this paper, I discuss the provision of dynamically based index offence group work for forensic patients who are detained in long-stay residential secure care. I discuss the benefits of reflective, attachment theory-based therapies as complementary to the other models of therapy that are offered to forensic patients. In particular, I discuss the relevance of this type of psychotherapy to index offence work, using the example of a reflective recovery-based therapy group for forensic patients who have killed. I discuss the relevance of identity and agency change in the narratives of group members, illustrating with quotes from the group. I conclude with comment about resistance to such work, and the impact on therapists of working with the trauma of homicide perpetration.

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.

Radon concentrations in different types of dwellings in Israel

The average radon concentration in Israeli dwellings was assessed by combining the results of a 2006 radon survey in single-family houses with the results of a 2011 radon survey in apartments of multistorey buildings. Both surveys were based on long-term measurements using CR-39 detectors. The survey in multistorey buildings was intended to assess the influence of recent practices in the local building industry on the radon concentrations. These practices include the use of building materials with higher concentrations of the natural radionuclides in the last 20 y than before, as well as the improvement in sealing techniques over that period. Another practice in place since the early 1990 s is the building of a shielded area in every apartment that is known as an RSS (residential secure space). The RSS is a room built from massive concrete walls, floor and ceiling that can be hermetically sealed and is intended to protect its residents from a missile attack. The influence of the above-mentioned features on radon concentrations was estimated by dividing the participating apartments into two groups: apartments in buildings >20 y, built using building materials with low concentrations of the natural radionuclides, regular sealing and without an RSS and apartments in buildings newer than 10 y, built using building materials with higher concentrations of the natural radionuclides, improved sealing and including an RSS. It was found that the average radon concentration in apartments in new buildings was significantly higher than in old buildings and the average radon concentration in single-family houses was significantly higher than in apartments in multistorey buildings. Doses due to indoor radon were estimated on the basis of the updated information included in the 2009 International Commission on Radiological Protection statement on radon.

Education Secured? The School Performance of Adolescents in Secure Residential Youth Care

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.

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.