Gert Schout

Utrecht University Medical Center · Psychiatry

Can thwarted belongingness and perceived burdensomeness, risk factors for suicidal adolescents, be turned around by family group conferences? In this case study on Nick, a 17-year-old who undertook six suicide attempts, we (including Nick) share insights and learning opportunities on how family group conferences can be used. The thematic analysis s...

Op 1 januari 2015 werden de gemeenten verantwoordelijk voor jeugdzorg, participatie en de zorg aan langdurig zieken en ouderen, een operatie die ook wel bekend staat als de drie D’s, de drie decentralisaties. Een operatie die beleidsvrijheid zou brengen en vrij besteedbare middelen voor gemeenten. ‘Integraal´, ‘nabij’, ‘ontschot´, ‘maatwerk´, dat w...

A recent debate in the UK on the merits of randomised controlled trials in evaluating Family Group Conferencing is a reason to bring this debate to a wider audience than the UK. Other countries are also struggling with accountability and the desire to know what works in the light of public spending. This paper explores, debunks and rethinks ways of...

Family Group Conferencing is a new decision model to assign caring responsibilities among various actors in society, including the client, social networks, and professionals. The process of Family Group Conferencing in coercive psychiatry is delicate; nevertheless, it paves the way for courageous conversation, and it facilitates ownership over the...

Descriptive studies on the experiences of service users in psychiatric emergency wards are increasing. However, the experience of users throughout the whole psychiatric emergency procedure, the ‘patient journey’ from the moment of mental health crisis leading to admission in a psychiatric inpatient unit, has rarely been studied. This article aims t...

Alternatives for coercive treatment in psychiatry, based on partnership between clients, social networks and social workers, need to be given full attention. Despite its potential to inhibit isolation, self-exclusion and reduce coercion, organising Family Group Conferences (FGC) in this field is complex. The process of a FGC may evoke shame and unb...

De decentralisatieoperatie is formeel gereed. Veel burgers raken gewend aan de nieuwe gemeentelijke taken. Begrippen als “eigen kracht”, “burgerkracht” en “burgerparticipatie” duiken overal op. Maar doen die burgers wel echt mee? De massieve aanwezigheid van hulpverlening, al dan niet via gebiedsteams, wekt de indruk dat de overheid de mouwen opstr...

Background. Recovery is a journey not only of personal change but also of social reengagement. It underlines the essence of social environments that are supportive to the recovery of people with ongoing mental health issues. The process of recovery also affects other actors, and likewise these actors exert their influence on the recovery of their f...

There is discussion on the most appropriate research methodology to examine the efficacy of Family Group Conferencing (FGC). Randomised controlled trials (RCTs), despite their pitfalls, are considered by many to be the ‘golden standard’, but the argument is not compelling. In this paper, the theory on programme evaluation is discussed which offers...

Harro Labrujere. Bouwen op sociale veerkracht. Amsterdam: Kringwijs, 2018.

In de zomervakantie van 1998 las ik op een Franse camping het boek Van theemutscultuur naar walkman-ego van Harry Kunneman. Er zijn nog foto's van dat ik liggend in het gras met een thermoskan onder mijn hoofd gebiologeerd lig te lezen. Het boek zou mij doorslaggevend vormen. In de tijd eraan voorafgaand geloofde ik sterk in de mogelijkheden om geg...

Internationally, there are increasing initiatives that involve undergraduate nursing students as co-researchers. This paper discusses the inclusion of final year undergraduate nursing students as co-researchers in participatory health studies. It reports on a large-scale study (2009–2015) on the process and outcomes of Family Group Conferencing in...

In the field of participatory health research (PHR) and related action research paradigms, limitations of standard ethical codes and institutional review processes have been identified. PHR is highly situational and relational, part of a hierarchical health care context and therefore ethics of care has been suggested as a helpful theoretical approa...

The protective features that families and wider social relationships can have are required to meet the demands of life in contemporary Western societies. Choice and detraditionalization, however; impede this source of solidarity. Family Group Conferencing (FGC) and other life-world led interventions have the potential to strengthen primary groups....

A risk factor among suicidal adolescents is generally their inability to form and maintain relationships with other people. In the case that we investigated, the technique known as Family Group Conference (FGC) was used successfully to break through the adolescent's passivity and social isolation. The FGC also helped to alter the adolescent's convi...

Within the current Dutch policy context the role of informal care is revalued. Formal care activities are reduced and family and friends are expected to fill this gap. Yet, there is little research on the moral ambivalences that informal care for loved ones who have severe and ongoing mental health problems entails, especially against the backdrop...

The narrowing of the diverse fields of psychiatry to just the single dimension of the biomedical model has resulted in a situation where professions with a focus on curing (psychiatrists and psychologists) are favoured over those with a focus on caring and encouraging near communities to care for each other (nurses). The social engineering of menta...

From 2011 until 2013, forty-one family group conferences were organised for clients in a public mental health care (PMHC) setting in the north of the Netherlands. In total, 312 semi-structured interviews were done out of a possible number of 473 Family Group Conferencing (FGC) participants. A multiple case study brought four dynamics to the surface...

Worldwide, there is a growing emphasis on reducing coercion and involving social networks in the care of mental health clients. Nurses should encourage their clients to regain control over their lives, preferably with less coercion and with help from their social network. During four years, a Dutch evaluation study was deployed to determine the app...

Aim: This study examined the impact of family group conferences on coercive treatment in adult psychiatry. Background: Coercive treatment in psychiatry infringes the fundamental rights of clients, including the right to control their lives. A promising intervention is the family group conferences, which has the potential to prevent crises throug...

Family group conferencing (FGC) coordinators in public mental healthcare are confronted with clients who have little faith in professionals and organizations, who hold off decisions in their family life, who avoid care and who sometimes behave in a hostile manner. A lack of initiative to deal with their situation is not only reserved for clients –...

Ondanks de belangstelling voor familiebeleid, voor triadisch werken (Petry, 2011), voor de familie als bondgenoot (Klaassen, 2014), voor Resource Group Assertive Community Treatment (RACT) (Nordén et al., 2012 ), blijkt het ook in de ggz moeilijk om oog te krijgen voor de sociale hulpbronnen van cliënten, laat staan ze te benutten. In een eerdere p...

The number of compulsory admissions in Dutch psychiatry has increased in the past 25 years. The reduction of coercion with Family Group Conferences in youth care has been successful. How, when and under what conditions can Family Group Conferences reduce coercion in adult psychiatry, is subject of an extensive inquiry. This paper, however, focusses...

Egoloos hulpverlenen is een relatief onbekend begrip in de Jeugdgezondheidszorg (JGZ). Dit artikel is een weerslag van een onderzoek naar het begrip “egoloos hulpverlenen” van Gerritsen en de mogelijkheden ervan voor de JGZ. Egoloos hulpverlenen bouwt voort op een paradigma van indirecte maakbaarheid; primaire groepen worden gemobiliseerd om zelf e...

Family Group Conferencing (FGC) is a decision-making model where clients with their social network formulate their own plan. There is little experience with FGC in mental health care. We studied the outcomes of 41 conferences in a public mental health setting in the north of the Netherlands. We interviewed 312 respondents out of a total of 473 conf...

Older adults living in deprived areas are at risk of developing frailty and becoming care dependent. The aim of this qualitative study is to explore how community-dwelling, older adults living in deprived neighbourhoods address ageing issues. In-depth interviews were conducted with 20 participants who were community-dwelling (independently living),...

Egoless care and Preventive Youth Health Care. An exploration of possibilitiesEgoless care is a relatively unknown concept in Dutch Preventive Youth Health Care (PYHC).his article is the result of a study into the concept of “egoless care” coined by Gerritsen andits capabilities for PYCH. Egoless care builds on a paradigm of indirect makeability; f...

Community conferencing (CC) holds promise in terms of complementing the existing conflict resolution strategies in social housing. Between January 2011 and September 2013, we examined the process and impact of eleven community conferences in social housing practices in the north of the Netherlands using a naturalistic case-study approach. These pra...

Scholars in the Netherlands have recently questioned the evidence for the efficacy of Family Group Conferencing (FGC). Their criticism is that the research projects on FGC which have been carried out so far to examine its impact are meaningless, as there are only few studies which incorporated a randomised controlled trial (RCT) design. In this cri...

Although evictions are a known pathway into homelessness, little is known about the dynamics between evictees and their social and professional networks during the sequence of events leading to evictions. Contributing to the knowledge that would help policies to improve the evictions prevention practice, we aimed to explore the inter-relational dyn...

To understand whether and how Family Group Conferencing might contribute to the social embedding of clients with mental illness. Ensuring the social integration of psychiatric clients is a key aspect of community mental health nursing. Family Group Conferencing has potency to create conditions for clients' social embedding and subsequently can prev...

Clients in public mental health care have limited social capital; they lack trusting and mutually supportive relations within bonded groups and do not have access to supportive external groups. Family Group Conferencing (FGC) is a promising decision-making model to restore social ties and mobilise informal support. From January 2011 to September 20...

This paper contests the merits of Public Mental Healthcare (PMHC) and examines the mission and structure of PMHC as a service. A description of the mission and structure of PMHC as a service is lacking, and even reflections on the type of service provided are scarce. In market-driven healthcare systems, the power of self-care and informal care is o...

Social networks in Family Group Conferencing As a result of the political reform of the social welfare agenda in the Netherlands, a different approach in professional care is needed. The focus should shift from professional help to strengthening the capabilities of clients and mobilizing support from their social network. Family Group Conferencing...

Apparently failed family group conferences in client systems with limited recources Family group conferences are increasingly organized to mobilize social support for vulnerable people. Clients in public mental health care (PMHC) often have broken and faded networks, so they have limited resources to gain support from. Between the start of 2011 and...

In de openbare geestelijke gezondheidszorg (oggz) worden mensen geholpen die hulp nodig hebben maar er niet om vragen, of er niet om vragen bij het juiste adres. De doelgroep heeft vaak meerdere problemen tegelijk, zoals psychiatrische problemen, verstandelijke beperkingen, verslavingen, schulden, problemen met opvoeden of met wonen. De belangrijks...

Vrijwel alle publicaties over de oggz beginnen met de definities van de voormalige Nationale Raad voor de Volksgezondheid (NRV). Wij doen dat ook, omdat deze definitie goed laat zien waar de oggz voor staat.

In de voorgaande hoofdstukken is gezegd dat hulpverleners in de oggz met één been in de moederorganisatie staan en met het andere been in het oggz-netwerk actief zijn. Oggz-professionals moeten dus mensen zijn die vanuit verschillende registers kunnen opereren: het brede generalistische werken dat in de oggz gevraagd wordt en het meer specifieke da...

In de vakpers is er relatief veel belangstelling voor de mate van sociale kwetsbaarheid en de opstapeling van problemen die de doelgroep van de oggz kenmerkt. Veel minder aandacht is er voor de vraag hoe het komt dat de voorzieningen deze mensen niet bereiken. Hoe is het gesteld met de signalering, de opmerkzaamheid, de toegankelijkheid, de vasthou...

From January 2011 until December 2012, forty Family Group Conferences (FGCs) will be studied in the public mental health care (PMHC) setting in the province of Groningen, the Netherlands. Research should yield an answer to whether FGCs are valuable for clients in PMHC as a means to generate social support, to prevent coercion and to elevate the wor...

Family Group Conferencing for groups and neighbourhoods in public mental health care There is little knowledge on the impact of Family Conferencing (FGC) for groups and neighbourhoods in public mental health care (PMHC). This paper is a report of a study conducted to describe the course and outcomes of three community conferences in PMHC. FGC for n...

Since the introduction of Family Group Conferences (FGCs) in the Netherlands, there has been a steady growth in conferences being organised each year. Government policy emphasises the importance of empowering families to strengthen their ability to take responsibility for their own well-being. A recently adopted amendment in the Dutch Civil Code re...

Preventing evictions Background. An eviction is a dramatic event. There is little knowledge on the process that precedes an eviction and how to prevent evictions. Method. An exploratory descriptive study based on seven case studies. Results. The process of a evictions is multifaceted and complex, but is determined by discontent over unfulfilled exp...

Care avoidance refers to the condition wherein clients do not seek assistance and do not attend appointments although they are in need of help. Care avoidance is linked to another phenomenon, the inability to help clients with multiple and complex problems by social services and care facilities, in this article identified as care paralysis. The aim...

Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public mental health care. The present study reports on an ex...

This paper is a report of a study conducted to explore the competencies - especially deep-rooted personal qualities - of care providers who succeed in making contact and gaining trust with clients who are inclined to avoid the care they need. Demands, thresholds and fragmentation of services hinder the accessibility of health care, such that some s...

The aim of this article is to understand the dynamics that bring forth the production and reduction of care avoidance and care paralysis. Care avoidance and care paralysis not only coincide, they reinforce and recall each other. Sometimes care workers however produce situations in which these phenomena are pushed back, situations in which trust and...

This article reports findings of a research project evaluating the impact and implementation of an educational program that aims to prepare four teams of professionals for working within Public Mental Health Care (PMHC). The participants originate from various institutions like Mental Health Care Institutions, Social Work, Social Housing Organisati...

De Openbare Geestelijke Gezondheidszorg (OGGz) kan gezien worden als een complex netwerk van hulpverleners en instellingen die samenwerken op grond van afspraken die al dan niet geregeld zijn in een convenant. In dit interorganisationele werkverband is niet één centrale partij aanwezig die zijn wil dwingend aan anderen kan opleggen. Er zijn veel ac...

De openbare geestelijke gezondheidszorg (OGGz) staat sterk in de belangstelling. Recente gezinsdrama’s laten zien dat assertieve en gecoördineerde hulp moeilijk van de grond komt. Gert Schout deed aan de Rijksuniversiteit Groningen onderzoek naar de wisselwerking tussen zorgvermijding en zorgverlamming. Op basis daarvan pleit hij voor schaalverklei...