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 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 Population characteristics –Boys from 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 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’ 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” 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? 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 (%)

Outcome /2004 (%)

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” School drop-outs Illegal drug abuse Verbal and physical aggression vandalism Antisocial peers Staying out overnight

No perspectives - continued The “coach” – “educator” Fading away of boundaries and limits Institutional context “Procession of Echternach” “Asking Parents”

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 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” 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 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.) 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 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 (%)

Evolution Outcome (%)

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 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 Vzw Sporen Geldenaaksebaan 428 B-3001 Leuven BELGIUM Info: Gie Kiesekoms, clinical director Jan Tibo, program supervisor Gie Lambeir, family therapist