[Show abstract][Hide abstract] ABSTRACT: Background:
The Evidence-Based Practice Attitude Scale (EBPAS) was developed in the United States to assess attitudes of mental health and welfare professionals toward evidence-based interventions. Although the EBPAS has been translated in different languages and is being used in several countries, all research on the psychometric properties of the EBPAS within youth care has been carried out in the United States. The purpose of this study was to investigate the psychometric properties of the Dutch version of the EBPAS.
After translation into Dutch, the Dutch version of the EBPAS was examined in a diverse sample of 270 youth care professionals working in five institutions in the Netherlands. We examined the factor structure with both exploratory and confirmatory factor analyses and the internal consistency reliability. We also conducted multiple linear regression analyses to examine the association of EBPAS scores with professionals' characteristics. It was hypothesized that responses to the EBPAS items could be explained by one general factor plus four specific factors, good to excellent internal consistency reliability would be found, and EBPAS scores would vary by age, sex, and educational level.
The exploratory factor analysis suggested a four-factor solution according to the hypothesized dimensions: Requirements, Appeal, Openness, and Divergence. Cronbach's alphas ranged from 0.67 to 0.89, and the overall scale alpha was 0.72. The confirmatory factor analyses confirmed the factor structure and suggested that the lower order EBPAS factors are indicators of a higher order construct. However, Divergence was not significantly correlated with any of the subscales or the total score. The confirmatory bifactor analysis endorsed that variance was explained both by a general attitude towards evidence-based interventions and by four specific factors. The regression analyses showed an association between EBPAS scores and youth care professionals' age, sex, and educational level.
The present study provides strong support for a structure with a general factor plus four specific factors and internal consistency reliability of the Dutch version of the EBPAS in a diverse sample of youth care professionals. Hence, the factor structure and reliability of the original version of the EBPAS seem generalizable to the Dutch version of the EBPAS.
Full-text · Article · Nov 2015 · Health Research Policy and Systems
[Show abstract][Hide abstract] ABSTRACT: Most youth care interventions are not supported by evidence from experimental or quasi-experimental studies. Yet children and families have to be treated and financiers and policy makers are asking value for money. For these reasons, evidence from practice-based studies should not be overlooked. Particularly, strengthening the designs of these studies could yield useful indications of effectiveness. The present study shows how this can be done by analyzing consistency in group and individual outcomes over time and across locations. Pre- and post-measures of behavior problems were collected over nine consecutive years at three locations in The Netherlands from nearly 900 children whose families received Intensive Family Treatment (IFT), a home-based treatment for multi-problem families. Over the years, the overall effect size was 0.66 (range of 0.51-0.80). Further analysis showed that these effects were stable over time and across locations. The reliable change index showed that about 63% of the children improved significantly during treatment (range of 56-68%) and 9% deteriorated or relapsed (range of 6-13%). These changes were also stable over time and partially stable across locations. The consistency of these results serves as an empirical indication of the effectiveness of IFT. Due to the lack of studies using control groups, such consistency might help practitioners choose promising interventions that would support their clients and be accountable to financiers and policy makers.
No preview · Article · Nov 2015 · Children and Youth Services Review
[Show abstract][Hide abstract] ABSTRACT: Iedere ouder ervaart bij tijd en wijle weleens stress bij het opvoeden. Wanneer deze stress niet van tijdelijke aard is of wanneer de stress erg hoog wordt, kan professionele hulp ingeschakeld worden. Het vaststellen van de aard en ernst van de opvoedingsstress is dan van belang. De Opvoedingsbelastingvragenlijst (OBVL) is een recent ontwikkeld instrument hiervoor. De uitkomsten van het hier beschreven onderzoek geven positieve aanwijzingen voor de betrouwbaarheid en validiteit van de OBVL. De OBVL is ontwikkeld voor instellingen voor jeugdzorg, maar is ook op andere terreinen van zorg voor kinderen goed bruikbaar. De lijst is geschikt voor screening, diagnostiek en evaluatie van behandelingen.
[Show abstract][Hide abstract] ABSTRACT: The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children.The aim of the current study was to observe the pedagogical interventions of group care workers within residential youth care and their associations with child behaviors.Group care worker interventions and child behaviors were videotaped during structured observations. Participants included 95 children (64 % boys, M age = 9.19) and 53 group care workers (74 % female, M age = 33.79 years). A coding system was developed to code pedagogical interventions and child behaviors.It showed that group care workers mainly used positive pedagogical interventions (warmth/support and positive control) and seldom used negative pedagogical interventions (permissiveness and negative control). Frustration and anger of children was associated with positive controlling interventions and permissiveness of group care workers. The hypothesis that child anxiety and nervousness is associated with warm and supportive interventions could not be confirmed.Pedagogical interventions should be part of education, training, and supervision of group care workers.
Full-text · Article · Apr 2014 · Child and Youth Care Forum
[Show abstract][Hide abstract] ABSTRACT: Group care workers in residential youth care are considered important in influencing behavioral development of children. In spite of this, their role has largely been neglected in research on residential care. The aim of the current study was twofold. First, longitudinal changes in group care worker interventions and child behaviors were investigated separately. Second, bidirectional influences between group care worker interventions and child behaviors were investigated. Group care workers completed the Group care worker Intervention Checklist and Child Behavior Checklist for128 children (66% boys, mean age 8.63 years) at the beginning of the treatment and at two measurement intervals that followed (6 and 12 months, respectively). Most results contradicted the predictions. There was no change in controlling and warm and supportive interventions by group care workers. Autonomy granting interventions increased during treatment. Second, there were no changes in externalizing and internalizing behaviors of children over time. Third, cross-lagged analyses revealed that higher levels of controlling interventions increased externalizing problems of children. In the opposite direction, higher levels of children's externalizing problems were associated with an increase in controlling interventions of group care workers. In addition, higher levels of children's internalizing problems were associated with lower subsequent levels of autonomy granting interventions. These significant longitudinal paths were found only for the first phase of treatment. This study emphasizes the potential of the role of group care workers in residential youth care. Residential institutions should be aware of the dynamics between group care workers and children. Training and ongoing supervision in effective responses to behavior problems can increase the effect of group care worker interventions on child behavioral changes.
Full-text · Article · Apr 2014 · Children and Youth Services Review
[Show abstract][Hide abstract] ABSTRACT: Routine Outcome Monitoring refers to regular measurements of clients' progress in clinical practice, aiming to evaluate and, if necessary, adapt treatment. Clients fill out questionnaires and clinicians receive feedback about the results. Studies concerning feedback in youth mental health care are rare. The effects of feedback, the importance of specific aspects of feedback, and the mechanisms underlying the effects of feedback are unknown. In the present study, several potentially effective components of feedback from Routine Outcome Monitoring in youth mental health care in the Netherlands are investigated.
We will examine three different forms of feedback through a three-arm parallel-group randomized controlled trial. 432 children and adolescents (aged 4 to 17 years) and their parents, who have been referred to mental health care institution Pro Persona, will be randomly assigned to one of three feedback conditions (144 participants per condition). Randomization will be stratified by age of the child or adolescent and by department. All participants fill out questionnaires at the start of treatment, one and a half months after the start of treatment, every three months during treatment, and at the end of treatment. Participants in the second and third feedback conditions fill out an additional questionnaire. In condition 1, clinicians receive basic feedback regarding clients' symptoms and quality of life. In condition 2, the feedback of condition 1 is extended with feedback regarding possible obstacles to a good outcome and with practical suggestions. In condition 3, the feedback of condition 2 is discussed with a colleague while following a standardized format for case consultation. The primary outcome measure is symptom severity and secondary outcome measures are quality of life, satisfaction with treatment, number of sessions, length of treatment, and rates of dropout. We will also examine the role of being not on track (not responding to treatment).
This study contributes to the identification of effective components of feedback and a better understanding of how feedback functions in real-world clinical practice. If the different feedback components prove to be effective, this can help to support and improve the care for youth.Trial registration: Dutch Trial Register NTR4234.
[Show abstract][Hide abstract] ABSTRACT: In deze studie beschrijven we de ontwikkeling van Families First (ff) in Nederland tussen 2003-2010 en toetsen we de getrouwheidshypothese: meer en beter volgens het model handelen leidt tot een betere uitkomst. We analyseren behandelgegevens van 4493 gezinnen die ff hebben ontvangen en gaan na in hoeverre de behandeling aan 12 van tevoren gedefinieerde aspecten voldoet. Tien daarvan vormen een indicatie voor behandelingsgetrouwheid. De resultaten laten zien dat ff de doelgroep goed bereikt (94%), de behandelingsgetrouwheid groot is (86%) en dat uithuisplaatsing bij afsluiting van de behandeling veelal wordt voorkomen (88%). De getrouwheidshypothese wordt bevestigd, echter met als belangrijke kanttekening dat de behandelingsaspecten Beschikbaarheid, Begeleiding en Betrokkenheid van de plaatser pas een (positieve) invloed op het voorkomen van uithuisplaatsing kunnen uitoefenen als eerst en volledig is voldaan aan een groep behandelingsaspecten die bestaat uit Specificiteit, Tussenevaluatie, Duur en Doelevaluatie. Bovendien blijken drie van de twaalf behandelingsaspecten géén (Snelheid en Doelgerichtheid) of zelfs een negatieve invloed (Intensiteit) te hebben op het voorkomen van uithuisplaatsing. Verschillende verklaringsvragen worden gesteld om verder zicht en grip te houden op de relatie tussen de behandelingsgetrouwheid en uitkomsten van ff.
No preview · Article · Aug 2013 · Kind en adolescent
[Show abstract][Hide abstract] ABSTRACT: Background
By interacting with children, group care workers shape daily living environments to influence treatment. Current literature provides little knowledge about the content of youth residential care.
In this study, a questionnaire called the Group care worker Intervention Checklist was developed.
Group care workers completed the questionnaires for 212 children placed in youth residential care in the Netherlands.
Factor analyses revealed three constructs: controlling, warmth/support, and autonomy granting. Reliability of these scales proved to be good. Controlling was associated with Externalizing Behavior Problems while both Warmth/Support and Autonomy Granting were associated with Internalizing Behavior Problems.
These findings imply that group care worker interventions can be reliably measured and are related to child problem behavior.
Full-text · Article · Oct 2012 · Child and Youth Care Forum
[Show abstract][Hide abstract] ABSTRACT: Emotional and behavioral problems assessed with the Child Behavior Checklist (CBCL) were analyzed from 2,739 Dutch children referred to Families First (FF) or Intensive Family Treatment (IFT) from 1999 to 2008, to examine time trends. From the year 2004 onward, six of the eight CBCL-syndrome scales yielded significant decreases from the reference year, 1999. Analyses of statistical interactions indicated that on some scales in later years, younger children and boys scored lower than in 1999, and children referred to FF showed more delinquent behaviors in later years compared with in 1999; whereas, children referred to IFT showed less delinquent behavior than in 1999. These results might be explained by structural changes in the Dutch youth care system, by a huge growth of the number of treated children, by an incident in Dutch youth care, and also by the introduction of new methods of home-based treatment for delinquent youth. An implication of the current results is to consider home-based services more seriously as an alternative for out-of-home placement.
No preview · Article · Sep 2012 · Journal of Emotional and Behavioral Disorders
[Show abstract][Hide abstract] ABSTRACT: Background
In 2005 a new compulsory residential treatment program was developed for adolescents in need for protection against themselves or their environment.
The aim of the present study was to examine the association of structural treatment characteristics of this new residential treatment program (i.e., duration of treatment, discharge status, and group composition in terms of sex) with post-treatment functioning. Additionally, the number of pre-treatment risk factors was included in the model.
A total of 301 adolescents (174 boys, 127 girls), with a mean age at time of admittance of 15.50 (SD = 1.26) participated in this study. The number of risk factors was derived from treatment files of the adolescents at time of entrance. Six months after discharge, adolescents participated in a telephone interview to measure ten post-treatment variables indicating how well they were doing.
The results showed that duration of treatment was related to post-treatment living situation, in that adolescents who were in treatment for shorter durations were more likely to live on their own after treatment. For discharge status, findings suggested that adolescents who were regularly discharged had more frequent contact with their family; however, they also showed higher alcohol consumption 6 months after treatment. Group composition was related to the girls’ official offending, indicating that girls placed in mixed-sex groups showed significantly fewer official police contacts than did girls in girls-only treatment groups.
Overall, structural treatment characteristics were hardly related to the adolescents’ functioning after treatment. Suggestions for future research are discussed.
Full-text · Article · Aug 2012 · Child and Youth Care Forum
[Show abstract][Hide abstract] ABSTRACT: The present study examined the association among sexual behavior and treatment improvement of institutionalized girls. Treatment files of 174 girls (M age = 15.71, SD = 1.14) were analyzed to obtain information about the sexual behavior of girls before admission. Based on their sexual behavior, girls were classified into three subgroups: girls showing sexually normative behavior (29%), girls showing promiscuous behavior (43%), and girls with a history of forced prostitution (29%). A subsample of 95 girls was also asked to complete questionnaires to measure treatment improvement. The findings revealed no differences in self-reported problem behavior between the subgroups at entrance. Over time differences between the subgroups were found, indicating that the girls in the different subgroups might require a different treatment approach. Further research that would include larger samples is needed to explore specific treatment needs.
No preview · Article · Jul 2012 · Residential Treatment for Children & Youth
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to examine the treatment progress of both adolescent's and their families' functioning in a new compulsory residential treatment program. The sample consisted of 339 admitted adolescents (56.3% boys). The mean age at time of entry was 15.69 (SDÂ =Â 1.30). Adolescents stayed on average 9.42Â months (SDÂ =Â 4.66) in a new residential treatment program. Data on adolescents' internalizing and externalizing problems were assessed using self-reports, parent reports, and group care worker reports. In addition, adolescents reported their substance use and delinquency and parents also reported family functioning and level of perceived parental stress. The findings revealed a significant decrease in adolescents' self-reported internalizing and externalizing problems, delinquency, and substance use. According to parent ratings, a significant improvement was found concerning adolescents' problem behaviors during treatment. However, according care worker ratings, adolescents showed no improvement on internalizing problems and showed an increase in externalizing problems. Concerning families, although there was no improvement in family functioning, parental stress significantly improved over time. Further research should examine whether improvements experienced during treatment are maintained after treatment.
No preview · Article · Oct 2011 · Children and Youth Services Review
[Show abstract][Hide abstract] ABSTRACT: In the present study, group care workers' behavior toward adolescents' problem behavior was measured. The sample consisted of 126 adolescents (M age = 15.80, SD = 1.23, 56% boys), residing in a new Dutch compulsory residential treatment program. Latent growth curve analyses revealed that group care workers exerted more structuring and controlling behavior toward adolescents with externalizing problems and more warmth and support toward adolescents with internalizing problems. No associations were found between group care workers' behavior and the adolescents' treatment progress. Clinical implications of these findings and suggestions for future research are discussed.
Full-text · Article · Jul 2011 · Residential Treatment for Children & Youth
[Show abstract][Hide abstract] ABSTRACT: Vroegtijdig ingrijpen bij jonge kinderen met ernstige gedragsproblemen kan delinquent gedrag in de adolescentie voorkomen. Sinds 2003 is in Nederland daartoe de interventie STOP4-7 beschikbaar, die zich richt op zowel het kind als de ouders en de leerkracht. Uit onderzoek blijkt dat de interventie doeltreffend is. De effectiviteit kan waarschijnlijk verder verbeteren als ouders en leerkrachten meer individuele ondersteuning krijgen.
[Show abstract][Hide abstract] ABSTRACT: Although young persons with severe and complex emotional and behavioural problems are often referred to the outpatient unit of the mental health service, little information is available about whether these problems increase over the years. This information is urgently needed in order to ensure that the mental health service provides adequate care.
To obtain more insight into any increase in young persons’ emotional and behavioural problems that may occur over a period of six years following referral to an outpatient unit of the mental health service.
The nature, severity and complexity of the emotional and behavioural problems of 123 young persons (1999) and of 149 young persons (2005) at the time of the referral - as rated by their parents on the basis of the Child Behavior Checklist (CBCL) - were assessed; the young persons’ records were also checked for background characteristics.
Compared to 1999, the year 2005 saw a slight decrease in the severity of the problems existing at referral; social problems also declined significantly compared to 1999. Problems identified in the 2005 group often seemed less complex than in 1999. The severity of delinquent behaviour as measured on the Delinquent Behaviour Scale seems to have risen in the 12 to 18 age group in 2005, whereas the severity declined in the 4 to 11-year olds.
Emotional and behavioural problems as reported by the parents at the time their children were referred to the mental health service do not increase.
No preview · Article · Jan 2011 · Tijdschrift voor psychiatrie