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The outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence: A multi-level meta-analysis
Affiliation:1. Juzt (Quality and Innovation unit), Erasmusweg 34, 4834 AA Breda, The Netherlands;2. University of Amsterdam (Department of Forensic Child and Youth Care Sciences), Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands;3. Leiden University of Applied Sciences (Youth Expert Centre), Zernikedreef 11, 2333 CK Leiden, The Netherlands;4. Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands;1. Dimence Mental Health Care, Deventer, The Netherlands;2. Centre for Special Needs Education and Youth Care, Faculty of Behavioural and Social Sciences, University of Groningen, The Netherlands;3. Department of Child and Adolescent Psychiatry, VU University Medical Center (VUMC), Amsterdam, The Netherlands;4. Department of Clinical Chemistry and Hematology, Gelre Hospitals, Apeldoorn, The Netherlands;5. University Centre St. Radboud & Karakter UMC, Child and Adolescent Psychiatry, Nijmegen, The Netherlands
Abstract:ObjectiveThe outcome of institutional youth care for children is heavily debated. This multilevel meta-analysis aims to address the outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence in economically developed countries. A gain of knowledge in this area may help the decision for referral of children to institutional youth care or other types of care (e.g., foster care or community-based care), and improve outcomes for children in youth care.MethodsOf 19 controlled studies (15.526 participants), 63 effect sizes of behaviour problems (externalizing, internalizing, and total), skills (social and cognitive) and delinquency were computed based on comparisons between institutional Evidence-Based Treatment (EBT), institutional Care As Usual (CAU), non-institutional EBT, and non-institutional CAU.ResultsInstitutional CAU showed a small-to-medium negative significant effect compared to non-institutional CAU (d =  0.342). Furthermore, children in institutional care showed slightly more delinquent behaviour compared to children in non-institutional care (d =  0.329). Significant moderating effects were also found for study design, year of publication and sex of the child.ConclusionsChildren receiving non-institutional CAU (mostly foster care) had slightly better outcomes than children in institutional CAU (regular group care). No differences were found between institutional and non-institutional care when institutional treatment was evidence-based. More research is needed on the conditions that make established treatment methods work in institutional care for (young) children.
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