Safety First! Residential Group Climate and Antisocial Behavior: A Multilevel Meta-analysis

A systematic review and multilevel meta-analysis was performed (28 studies and 313 effect sizes) on the relation between residential group climate (i.e., safety, atmosphere, repression, support, growth, structure) and antisocial behavior, including aggression and criminal recidivism. A systematic search was conducted in PsychINFO, ERIC, and OVID Medline up to February 2023. Results showed a small but significant association (r = .20) between residential group climate and antisocial behavior, equivalent to a 23% reduction of antisocial behavior in all clients receiving care in a residential facility with a therapeutic group climate. Moderator analyses showed that experienced safety was more strongly related to antisocial behavior (r = .30) than the other dimensions of group climate (.17 < r < .20), while the effect size was somewhat larger for adults (r = .24) than for youth (r = .15). We conclude that residential facilities should consider safety as a priority and should involve clients in a positive process of change through the development of a therapeutic environment and delivery of evidence-based treatment, addressing their needs from the perspective of rehabilitation.

Group Climate in Residential Youth Care: Development and Validation of the Group Climate Instrument-Revised

Group climate in residential youth care is considered to be essential for treatment of youth and young adults. Various instruments exist to measure quality of living group climate, but some are lengthy, use complicated wording, which make them difficult to fill out by youth and individuals with a mild intellectual disability. The present study describes the development and rationale for the Group Climate Instrument-Revised (GCI-R). Construct validity and reliability of the GCI-R were examined by means of Confirmatory Factor Analysis (CFA) in a two-step validation process using a construction sample (n = 190 youth, representing 41 groups) and a validation sample (n = 207 youth, representing 42 groups). Results indicated a good fit of a five-factor model (Support, Growth, Physical Environment, Peer interactions, and Repression). Reliability of the scales was good. These findings indicate that the GCI-R can be used as a parsimonious, valid, and reliable instrument to assess perceptions of group climate in youth. Recommendations for future research and practice are suggested.

Self-perceived views on offender rehabilitation in detained adolescent boys: a qualitative analysis in the context of the good lives model

Introduction

An upcoming offender rehabilitation model, the Good Lives Model (GLM), proposes that effective offender rehabilitation should adopt a dual focus: reducing recidivism risk as well as enhancing the offender's well-being. To achieve this, the GLM suggests rehabilitation should include the prosocial fulfilment of a universal set of human needs termed "primary goods." A focus on primary goods attainment and well-being is hypothesized to improve treatment motivation and achieve more sustainable desistance from future offending. Although this model sounds promising, empirical evidence for these assumptions is limited, especially among youth.

Methods

Twenty Flemish and Dutch detained adolescent boys (14 to 17 years old at the time of their arrest) were interviewed during their detention using a semi-structured interview. They were asked about their well-being, needs and goals during rehabilitation, their treatment motivation, and their views on recidivism and rehabilitation.

Results

The results show that a match between the boys' well-being needs, and the treatment goals set in collaboration with the institution could improve treatment motivation and rehabilitation efforts. The boys also mentioned other factors with a positive impact on their treatment motivation: increased levels of freedom and autonomy; having a future (prosocial) perspective; investing in a therapeutic alliance; and, working on individual factors (i.e., improving coping skills, school or work skills, and relationships with prosocial friends and family).

Discussion

These factors closely align with working on the GLM primary goods of "excellence in work and play," "excellence in agency," and "relatedness," which can be helpful in enhancing well-being and treatment motivation in offender rehabilitation.

A Tailored Approach for Justice Involved Youth With an Intellectual Disability: The Suitability of a Small-Scale Community-Integrated Approach

Youngsters with intellectual disabilities are overinvolved within the youth justice system. The aim of this study was to explore the suitability of a small-scale community-integrated approach for justice involved youngsters with intellectual disabilities. This study compared the numbers of transfers, the number, type, and rate of change in incidents, and the possible mediating effect of resilience thereon, between 40 youngsters with and 19 youngsters without intellectual disabilities, placed in a small-scale facility. There were no differences in the number of transfers, the number, type, and rate of change in incidents, and no mediating effect of resilience was found. A small-scale community integrated approach for youth justice facilities can be suited to provide tailored placement for youngsters with intellectual disabilities, given the presence of protective factors and motivation. Both youngsters with and without intellectual disabilities showed a low number of incidents and were able to continue or initiate structural daytime activities.

Best practice recommendations on the application of seclusion and restraint in mental health services: An evidence, human rights and consensus-based approach

WHAT IS KNOWN ON THE SUBJECT?: Seclusion and restraint still regularly occur within inpatient mental health services. The Council of Europe requires the development of a policy on for instance age limits, techniques and time limits. However, they only define the outer limits of such a policy by indicating when rights are violated. Within these limits, many choices remain open. Staff and service managers lack clarity on safe and humane procedures. Research literature provides limited and contradictory insights on these matters. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The study resulted in 77 best practice recommendations on the practical application of restraint and seclusion as last resort intervention in inpatient youth and adult mental health services, including forensic facilities. To our knowledge, this is the first study in which the development of recommendations on this topic is not only based on scientific evidence, but also on an analysis of European human rights standards and consensus within and between expert-professionals and experts-by-experience. This approach allowed to develop for the first time recommendations on time limits, asking for second opinion, and registration of seclusion and restraint. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The 77 recommendations encourage staff to focus on teamwork, safety measures, humane treatment, age and time limits, asking for second opinion, observation, evaluation and registration when applying seclusion and restraint as last resort intervention. The implementation of the best practice recommendations is feasible provided that they are combined with a broad preventive approach and with collaboration between service managers, staff (educators) and experts-by-experience. Under these conditions, the recommendations will improve safety and humane treatment, and reduce harm to both service users and staff.

ABSTRACT

INTRODUCTION: Seclusion and restraint still regularly occur within inpatient mental health services. Professionals lack clarity on safe and humane procedures. Nevertheless, a detailed policy on for instance age limits, techniques and time limits is required.

AIM

We developed recommendations on the humane and safe application of seclusion, physical intervention and mechanical restraint in inpatient youth and adult mental health services, including forensic facilities.

METHOD

After developing a questionnaire based on a rapid scientific literature review and an analysis of human rights sources stemming from the Council of Europe, 60 expert-professionals and 18 experts-by-experience were consulted in Flanders (Belgium) through a Delphi-study.

RESULTS

After two rounds, all but one statement reached the consensus-level of 65% in both panels. The study resulted in 77 recommendations on teamwork, communication, materials and techniques, maximum duration, observation, evaluation, registration, second opinion and age limits.

DISCUSSION

Combining an evidence, human rights and consensus-based approach allowed for the first time to develop recommendations on time limits, asking for second opinion and registration.

IMPLICATIONS FOR PRACTICE

When combined with a preventive approach and collaboration between service managers, staff (educators) and experts-by-experience, the recommendations will improve safety and humane treatment, and reduce harm to service users and staff.

The bumpy road to change: a retrospective qualitative study on formerly detained adolescents' trajectories towards better lives

BACKGROUND

Currently, the risk-oriented focus in forensic youth care is increasingly complemented by a growing interest in strengths-based approaches. Knowledge on how detention and the subsequent period in the community is experienced by adolescents, and which elements are helpful in achieving better lives can contribute to this emerging field. The current study aimed to retrospectively explore adolescents' experiences from the moment they were detained until 6 to 12 months after they left the institution, identifying positive aspects and strengths.

METHODS

In-depth interviews were conducted with 25 adolescents (both boys and girls, 15-18 years old) on average 8 months after discharge from a closed institution in Belgium. A thematic analysis was performed using NVivo 11.

RESULTS

Five themes and corresponding subthemes were identified: (1) adolescents' own strengths and resilience, (2) re-building personally valued lives, (3) making sense of past experiences, (4) moving away from a harmful lifestyle, and (5) (in-)formal supports. Most adolescents are on their way to finding a new balance in life, however, for a subgroup of them, this is still fragile. Adolescents highly emphasize the importance of feeling closely connected to at least one person; to receive practical help with regard to finances, work and housing; and to be able to experience pleasure and joy in their lives.

CONCLUSIONS

Adolescents' narratives suggest that starting a journey towards a normative good life often goes along with an initial difficult period because of a sense of loss with regard to their former life. This stresses the importance of targeting rehabilitation towards prosocial goals and enhancing adolescents' quality of life on those life domains that matter most for them. Furthermore, we stress the importance of helping adolescents in overcoming structural barriers as a first step in supporting them in their trajectories towards better lives.