Closed institutions and their alternatives what works
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Closed institutions and their alternatives: What works?. Presentation Eusarf Conference 22th September, 2005 ,Paris. Situation in Belgium. Regional Juvenile Courts Common answer to serious offences = forced residential treatment

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Closed institutions and their alternatives what works

Closed institutions and their alternatives: What works?

Presentation Eusarf Conference

22th September, 2005 ,Paris


Situation in belgium

Situation in Belgium

  • Regional Juvenile Courts

  • Common answer to serious offences = forced residential treatment

  • In the Flemish region (population 6 million people): 3 closed institutions for boys run by the Flemish government (Cap.182) and one run by the federal government (Cap. 25)


Closed institutions in flanders

Closed Institutions in Flanders

  • Population characteristics

    • Boys from 12 -18 y

    • Delinquent behaviour

    • And/or serious conduct problems

      • Aggression

      • Oppositional behaviour (acting-out)

  • Limited Capacity

    • cap. 212 for boys

  • Boys are isolated from participation in society


Our open organisation

Our (open) organisation

  • Vzw Sporen: different departments

  • Department ‘De Pas’ :

    • focus on adolescent boys (14 y - max 21 y)

    • goal = re-integration

    • 3 treatment models available

      • residential care

      • intensive family preservation

      • independent living of youngsters with intensive coaching from the service


History of de pas

History of ‘De Pas’

  • Started in 1991 as a training group for boys to become independent of their families.

  • Reasons for referrals by judges

    • assumption: residential care = safer than living in the own environment

    • Residential care used as a sanction

    • assumption: independence = a good thing


A political problem

“ a political problem”

  • Critical incidents

  • Public opinion: “youth protection” – “youth sanction”

  • Appeal of the juvenile court magistrates

  • European Convention on Children’s Rights

  • Overcrowded Community Institutions (terminal)

  • 1st Youth Detention Centre (Everberg)

  • Catg 1 B: alternative programs

  • Legally stated continuum from less to more intervening measures


What did happen

What did happen?

  • A little progress in practical skills (cooking, public transportation, cleaning..)

  • Therapists focused on their own relation with the individual boys and tried to teach them how to live without adult caretakers around them

  • Massive negative impact of peers: reinforcement of anti-social behaviour in the institution (aggression, drug abuse, vandalism..) This overruled the impact of the therapists.

  • Little involvement of family members

  • Lots of incidents and poor outcomes

  • Very high turnover staff members


Outcome 2000 2002

Outcome 2000-2002 (%)


Outcome 2003 06 2004

Outcome 2003 - 06/2004 (%)


Why did we make a shift

Why did we make a shift ?

  • We had to!

  • Traditional residential setting aiming for autonomy/independence of the adolescent boys

  • Culture of aggression

  • Priority to “personal relationship” – “negotiations”

  • Attitude towards families: theoretical view/reality


No perspective no future

No perspective – “No Future”

  • School drop-outs

  • Illegal drug abuse

  • Verbal and physical aggression

  • vandalism

  • Antisocial peers

  • Staying out overnight


No perspectives continued

No perspectives - continued

  • The “coach” – “educator”

  • Fading away of boundaries and limits

  • Institutional context

  • “Procession of Echternach”

  • “Asking Parents”


New goals

New goals

  • coach adults to reinforce responsible behaviour

  • help restoring links with school, work, family..

  • be very clear about society rules

  • primary goal = reintegration in family

  • Progress to be proven by facts

    • ex: goes daily to school/negative on drugstest and so on...

  • Period of living in residence = period used to re-engage family

  • Goals of the adolescents should address concerns of family and/or court


Staff issues

Staff Issues

  • Organisation of training and supervision is inspired by family treatment models like

    • multi-systemic treatment

    • Homebuilders /families first/Fam/Fim

  • All workers must develop skills to engage family members and others meaningful persons

  • Worker can no longer take over tasks and responsibilities of caregivers


  • The gearbox of de pas

    The Gearbox of “De Pas”

    • Vector 1: context-oriented

    • Vector 2: group-oriented

    • Vector 3: individual-oriented

    • Vector 4: making sense of school/work

    • Vector 5 & 6: drugs and aggression

    • Vector 7: attitudes of the social worker


    Cano principles

    CANO-principles

    • Reconnecting the youngster with his context

    • Positive belief in possibilities

    • Problem-solving attitude

    • Strengthening of the youngster’s natural network

    • Sharing responsabilities = re-engaging families

    • Integrated model


    Principles mst henggeler et al

    Principles MST (Henggeler, et. al.)

    • Understand the Fit Between the Identified Problems and Their Broader Systemic Context

    • Emphasize the Positive and Use Systemic Strengths as Levers for Change

    • Promote Responsible Behavior and Decrease Irresponsible Behavior among Family Members

    • Interventions should be Present-Focused and Action-Oriented, Targeting Specific and Well-Defined Problems

    • Interventions should Target Sequences of Behavior within and between Multiple Systems that Maintain Identified Problems

    • Interventions should be Developmentally Appropriate and Fit the Developmental Needs of the Youth

    • Interventions should Require Daily or Weekly Effort by Family Members

    • Intervention Effectiveness is Evaluated Continuously from Multiple Perspectives, with Providers Assuming Accountability for Overcoming Barriers to Successful Outcomes

    • Promote Treatment Generalization and Long-Term Maintenance of Therapeutic Change by Empowering Care Givers to Address Family Members’ Needs across Multiple Systemic Contexts.


    Beliefs homebuilders families first

    Beliefs Homebuilders -Families First

    • Safety for children is our highest priority.

    • The family is the focus of service.

    • Children are better off with their own families whenever safely possible.

    • Troubled families can change.

    • Families are colleagues of the staff members.

    • Families’ beliefs and values must be respected.

    • It is the worker’s job to instil hope.

    • A crisis is an opportunity for change.

    • Inappropriate interventions can do harm.


    Recent outcomes

    Recent outcomes (%)


    Evolution outcome

    Evolution Outcome (%)


    Consequences for clinical practice

    Consequences for clinical practice

    This change = culture shock

    • new goals for all levels in the organisation

      • general agreement to work differently

    • different skills needed for all practitioners

      • changes always imply discomfort

      • other requirements, new job descriptions

    • old patterns tend to last longer than expected

    • new image must be made known to judges and referral agencies


    Consequences for the government policy

    Consequences for the Government Policy

    • Policy based on results, not on populism or (manipulated) public opinion

    • Recognition for changed needs of youth care organisations

    • investment in research (what works) instead of investing money in ‘more of the same’


    Contact

    Contact

    Vzw Sporen

    Geldenaaksebaan 428

    B-3001 Leuven

    BELGIUM

    Info: www.sporen.be

    ++32 16 387600

    Gie Kiesekoms, clinical director

    Jan Tibo, program supervisor

    Gie Lambeir, family therapist


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