Defining standards: a step towards evidence-based practice for children and youth with behavioural disorders Dejana Bouillet, Assistant Professor The Institute for the Social Research in Zagreb Antonija Žižak, Full Professor Faculty of Education and Rehabilitation Sciences, University of Zagreb MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Some Fact about Croatia Surface: km 2 Surface of the territorial sea: km 2 Number of islands, cliffs and reefs: Population: Capital: Zagreb, Children and youth: 37,26% Children in foster care: Children in institutions: MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Croatian Government Committee for Prevention (2002 / 2003) Two tasks: 1) Proposing standards Literature study Focus groups with stockholders Creating and proposing standards 2) Matching proposed standards with existing programs MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Proposed standards of good practice / programs FIRST LEVEL STANDARDS (professional values and principles) 1.Service users’ perspective 2.Orientation towards development of individual, family and community assets 3.Needs assessment as bases for intervention planning 4.Local, regional and national network of services SECOND LEVEL STANDARDS (conceptual aspects) 1.Promoting prevention 2.Integration of theory, science and practice 3.Support to the basic societal institutions- family and school 4.Alleviation of entry to formal social structure 5.Place on the continuum of interventions 6.Supportive to quick and effective intervening 7.Supportive to diverse and alternative interventions 8.Culturally sensitive intervention MALTA, 15. SEPTEMBER : SEBD CONFERENCE

9.Supportive to multimodal approach 10.Supportive to integrated approaches 11.Supportive to the intervention system flexibility 12.Relying on quality indicators and code of ethics THIRD LEVEL STANDARDS (programme framework dimensions) 1.Presence of long term, and short term goals 2.Clear mechanism of beneficiaries’ identification and selection 3.Clear statements regarding activities, performance and roles 4.Statements regarding education and supervision 5.Statements regarding monitoring and evaluation 6.Statements regarding sustainability MALTA, 15. SEPTEMBER : SEBD CONFERENCE Proposed standards of good practice / programs

First assessment - program characteristics: 239 programs: 83,7% primary prevention 44,3% free-time programs 30,1% social welfare programs 0.4% juvenile justice programs 90% short time programs MALTA, 15. SEPTEMBER : SEBD CONFERENCE First assessment - 4 independent evaluators: 1.None of assessed programs matched all proposed standards 2.Fourteen programs matched more than half standards – “potential model programs”

First assessment - matched standards: Most present standardsLeast present standards 1. level standards Orientation towards development of individual, family and community assets Needs assessment as bases for intervention planning 2. level standards Supportive to integrated approaches Relying on quality indicators and code of ethics 3. level standards Clear statements regarding activities, performance and roles Statements regarding monitoring and evaluation MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Second assessment – basic information about programs: 11 potential model programs: 10 programs led by non-governmental organizations Target population: 2300 children and their parents 130 adolescents and their parents 440 school staff 140 other professionals 60 college students Duration - 5 to 15 years Coast estimation: from 34 to 300$ per subject MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Potential model programs – two examples Programs:Key program goals:Target population: MMPI strengthen family, school and community in supporting development of academic, social and emotional competences strengthen positive child development strengthen parents in developing parenting skills reduce behaviour problems – impulsive, violent behaviour and substance use increase sensibility of local community for children and families at risk coordinate community resources for best quality care 100 children 180 parents 50 school staff 23 professionals 2 decision makers Miraculous Croatia strengthen healthy, positive approach to life enable positive experiences in peer groups develop tolerance for differences improve communicational skills reduce conduct problems reduce consequences of traumatic experiences increase interest for nature, activities and skills for healthy life in nature 250 children 14 adolescents MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Results – percentage of matched standards First assessmentSecond assessment Increase All standards 59.0% to 77.0%62.3% to 90.1%2.5 to 22.9% 1. level standards50.0% to 80.7%57.7% to 92.3%3.9 to15.4% 2. level standards52.0% to 76.0%58.0% to 88.0%2.0 to 30% 3. level standards56.5% to 84.8%60.9% to 93.5%4.4 to 23.9% MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Second assessment - matched standards: Most present standardsLeast present standards 1. level standards Orientation towards development of individual, family and community assets Needs assessment as bases for intervention planning 2. level standards Preventing increase of existing disorders Support to basic social institutions Support to diversion and alternative interventions Support to flexibility in intervention system 3. level standards Clear statements regarding activities, performance and roles Mechanisms of identification and selection of beneficiaries Presence of long and short terms goals Statements regarding sustainability MALTA, 15. SEPTEMBER : SEBD CONFERENCE

Concluding remarks: Question: was this a step towards evidence-based practice? Answers: standards were proposed through ad-hock procedure a great number of programs voluntarily participated in assessment What else is possible in a country of “small numbers” MALTA, 15. SEPTEMBER : SEBD CONFERENCE