Aims: Patient-reported outcomes have become an important source of information to guide service provision. Although opiate substitution treatment (OST) is an evidence-based and widely available intervention for opiate dependent individuals, evaluation studies have primarily focused on objective outcome indicators rather than on clients' perspectives and personal experiences. This study aims to assess opiate users' satisfaction with various aspects of substitution treatment and their subjective experiences and expectations regarding the provision of psychosocial support. Methods: The study sample consisted of 77 opiatedependent individuals who had been involved in OST for at least three months in some cities in Belgium. Qualitative interviews were used to explore clients' subjective experiences, in addition to some quantitative measures. Findings: About half of the respondents recently received some form of psychosocial support and they were generally satisfied about these services. However, the number of persons who wanted psychosocial support clearly outnumbered those actually receiving these services. Respondents stressed the importance of building trusting relationships with OST staff. Also, the need for more flexible and individualised support was emphasised. Conclusions: Compared with other stakeholders' perspectives or traditional outcome indicators, service users' subjective experiences shed an alternative light on the impact of opiate dependence and OST on individuals' daily lives. This information should be incorporated in individual treatment planning and when designing and evaluating OST services.

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Continuity of care is seen as a challenge for youth care services. Research on continuity of care in relation to youth care services is scarce, and there is a strong tendency to overly stress the managerial and technical aspects of care. However, research on continuity from a youngster’s perspective suggests a more complex construction of continuity. The connection with youth care services is especially under pressure in the confrontation with difficulties and critical moments. In this narrative study, we aim at gaining insight into youngsters’ different strategies in vulnerable situations when facing difficulties in their trajectories in relation to youth care interventions. By retrospective reconstruction of their trajectories in relation to youth care interventions, youngsters were able to express significant moments in their biographical timeline. The narratives are analysed using the framework given in literature on users’ coping strategies in relation to dissatisfaction in services: loyalty, voice, exit and neglect. We have chosen three topical life stories of youngsters to represent the research findings that illustrate identified strategies of fighting, freezing and fleeing care, which are to be viewed as translations of the Hirschman coping strategies. However, a deeper analysis of these interactions results in a more complex view on strategies and shows that these can be misinterpreted by youth care workers. Different elements such as timing, clinical overshadowing or the pre-structured nature of youth care interventions are linked to this mismatch between what youngsters want and what youth care workers offer. Options are presented to handle these difficult interconnections.

Continuity is seen as an important aim for the quality of youth-care services. However, views on continuity are predominantly guided by experts, without much attention to user perspectives. This paper focuses on youngsters’ experienced continuity in relation to youth-care services. Twenty-five youngsters, who were in residential care or reached by low-threshold youth services, were interviewed about their experiences in and out of care. In thematically exploring the biographical narratives for important experiences of continuity, three major themes emerged: (i) the need for footholds in moments of existential chaos, (ii) the importance of timing of interventions to match the youngsters’ perspectives and (iii) the importance of the youngsters’ impact on their own care pathways. This study shows the need for support that is imbedded in a relational network within the context of youngsters in vulnerable situations. Rethinking youth services towards a better connection with these contexts is essential. Furthermore, the amount of control youngsters experience in their care interventions seems to be beneficial to the experience of continuity. It is argued that continuity should be seen as a process, in order to leave more space for negotiation and flexibility throughout the youngsters’ experiences in youth-care services.

In recent years, a growing trend to consider strengths and protective factors in studies on desistance from crime has emerged. The present study explores three formerly detained adolescents’ narratives, aiming to tease out how Quality of Life (QoL) and desistance interact in pathways towards a “better life.” The narratives suggest that the journey towards a better life is highly individual, and may unfold via multiple pathways characterized by an ambivalent relationship between QoL and desistance. Alongside the importance of individual aspects and social support, societal barriers and opportunities play a significant role in creating new chances to re-build a life and prosocial identities. This reflects earlier findings that desistance is not an individual responsibility. It is essential to support young people to overcome societal barriers that impede participation in society and living a good life. This research adds to growing evidence of strengths-based approaches to rehabilitation, such as the Good Lives Model (GLM).