A B S T R AC TThe client-therapist relationship is recognized as an important factor contributing to outcomes of child and youth care. Particularly in secure residential youth care, in which adolescents with mainly externalizing behaviour problems are often placed coercively, the clientstaff relationship seems to be important for the achievement of positive outcomes. The present study aims to assess the client-staff relationship for a group of 135 adolescents in secure residential care and factors associated with a positive relationship. The results show that adolescents, group care workers and teachers experience a limited affective bond in their relationship 2 months after the adolescents were admitted to the secure care centre. Adolescents do tend to use care workers and teachers as a secure attachment figure, which suggests that an affective bond is no precondition for the adolescents to experience staff as a secure base. Main predictors of a good relationship are the positive treatment skills of both group care workers and teachers. These findings point to the need for training of care workers and teachers so that they are better prepared for working with these adolescents.

This study compares the views of unaccompanied minors living in four different types of care facilities in the Netherlands: namely in foster care, small living units, children's living groups and campuses on their wellbeing, living circumstances and place in Dutch society. Interviews with 132 minors were both qualitatively and quantitatively analysed.

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Participation in decision-making procedures of young people in care is considered a key element that affects their current or future living circumstances and might improve the quality of decisionmaking on and delivery of provided services.This narrative literature review, covering the period 2000-2016, focuses on the opportunities of young people to participate, the challenges and facilitators to participation, and the outcomes of care related to participation.Sixteen studies met our search criteria. Several studies show that young people seem to have limited possibilities to "meaningful" participation in decision-making. Various challenges and facilitators in the participation process emerge with regard to the level of the young person, the professional, and the (sociocultural) context. None of the studies provides evidence for a connection between the "amount" of youth participation in decision-making and/or treatment during the care process and the outcomes of residential care. Implications for research and practice are reflected upon.

BackgroundAlthough secure residential care has the potential of reducing young people’s behavioral problems, it is often difficult to achieve positive outcomes. Research suggests that there are several common success factors of treatment, of which the client’s motivation for treatment and the quality of the therapeutic relationship between clients and therapists might be especially relevant and important in the context of secure residential care.ObjectiveThe objective of the present study was to explore the association of these potential success factors with secure residential care outcomes.MethodsA repeated measures research design was applied in the study, including a group of adolescents in a secure residential care center that was followed up on three measurements in time. Interviews and questionnaires concerning care outcomes in terms of adolescents’ behavior change during care were administered to 22 adolescents and 27 group care workers. Outcomes in terms of adolescents’ treatment satisfaction were assessed by the use of questionnaires, which were completed by 51 adolescents.ResultsAdolescents reported some positive changes in their treatment motivation, but those who were more likely to be motivated at admission were also more likely to deteriorate in treatment motivation from admission to departure. Treatment satisfaction was associated with better treatment motivation at admission and with a positive adolescent-group care worker relationship.ConclusionsThe results suggest that outcomes can be improved by a more explicit treatment focus on improving the adolescent’s treatment motivation and the quality of the adolescent-care worker relationship during secure residential care.