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Implementing MDET: Evaluating adaptations and effectiveness1496IntroductionLong-term care organisations for people with intellectual disabilities provide care to clients who might have complex needs for care, support and treatment. These complex needs may arise from additional disabilities such as visual, hearing, and motor impairments (Vlaskamp et al, 2007), as well as from challenging behaviour, for example apathetic, destructive, aggressive or self-harming behaviour (Emerson & Einfeld, 2011). To protect clients with intellectual disabilities, direct care staff and their surroundings in unsafe situations, care professionals may apply involuntary care. Examples of involuntary care include restrictive and coercive measures, such as pulling wheelchair brakes, seclusion, fixation or locked doors and cabinets (Schippers et al., 2018). In the Netherlands, care professionals are obliged under the Convention on the Rights of Persons with Disabilities (CRPD) (Nations, 2006) and the Care and Coercion Act (CCA) (Staatsblad, 2018) to respect and uphold clients%u2019 right to self-determination and apply involuntary care minimally and as briefly as possible. The organisations in which care professionals work are obliged to support care professionals to this end. Care needs of people with intellectual disabilities are complex, challenging behaviour is multidetermined (Hastings et al., 2013; Poppes et al., 2010), and involuntary care can take many shapes and forms (Schippers et al., 2018). Therefore, phasing out involuntary care requires multidisciplinary expertise. For that purpose, the Multi-Disciplinary Expertise Team (MDET) method was developed and proven effective in a randomised controlled trial (Schippers, 2019). However, being effective in one care organisation does not guarantee effectiveness when scaling out the method to other care organisations, because contexts of these organisations vary in size, structure and culture (Kersten et al., 2018; May et al., 2016). Implementing the MDET-method in other contexts may need adapting the method to provide a better fit (Chambers & Norton, 2016). Moreover, when executing MDET, effectiveness may be influenced by varieties in work routines, collaboration and communication among care professionals in a specific organisation (Bisschops et al., 2022; May et al., 2016). In this study, the MDET method was implemented in four care organisations. The aims were