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

Abstract

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.

Mental health treatment programs for children and young people in secure settings: A systematic review

“…Clients commonly maintain treatment outcomes for a few weeks after discharge, then experience declines [3,10,21,54,56,61,68]. Many do not maintain long-term outcomes [10,11,17,18,21] and are readmitted within a few years [9,11,15,35,57,64]. 8…”

“…The various objectives of secure treatment fall into six overall categories. They aim to address clients' mental health needs [6, 8, 16, 40, 52], reduce the risk of harm that clients currently pose to themselves [4,40,48], reduce the risk of harm that clients currently pose toor others [4,12,47], and reduce the risk that clients may pose to themselves and/or others in the future [2,12,33,35,47,53,54]. As clients experience complex needs across multiple life domains (e.g., physical health, education, work, living situation, family and social relationships) that affect and are affected by their signi cant mental health and behavioral concerns [17,21,33,35,40,44,53,55], Asecure treatment programs also aim to address these life domains [17,21,33,35,40,44,[53][54][55] to improve clients' quality of life [33].…”

Residential Youth Care Combined with Systemic Interventions: Exploring Relationships between Family-Centered Care and Outcomes

“…Our study shows that when a systemic intervention with a strong evidence base is implemented in combination with secure residential youth care, the average stay is reduced to less than 20 weeks (<5 months). This is not entirely surprising given that some combined trajectories of family-centered care at the residential group level and evidence-based systemic interventions explicitly aim to reduce the duration of residential stay to a maximum of for example, 6-8 weeks (Rovers et al, 2019).…”

“…In recent years, residential treatment is increasingly being combined with systemic interventions to enhance outcomes of adolescents and their families (Hoogeveen et al, 2017;Rovers et al, 2019;Trupin et al, 2011). Historically, residential treatment has been largely child-centered (Knorth et al, 2008;Sunseri, 2020).…”

“…It is hypothesized that combinations of residential care and systemic interventions ensure that behavioral improvements achieved during placement are maintained after departure (Knorth et al, 2008), with families showing improved family functioning (e.g., less parental distress, improved family empowerment, and caregiverchild relationships after treatment; Preyde et al, 2011;Smulders et al, 2018). In addition, these combinations may reduce the duration of placement, as these interventions aim for adolescents to return home as soon as possible or to live independently after placement (Rovers et al, 2019;Trupin et al, 2011).…”