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Summary2058Aims of the dissertationThis dissertation aimed to improve understanding of implementation processes in care organisations for people with intellectual disabilities, particularly regarding methods that reduce involuntary care practices, and to examine the effectiveness of these methods. Five main objectives were outlined for the dissertation. (1) To examine the impact of the introduction and full implementation of the CCA (Wet Zorg en Dwang) in the Netherlands, on the recording of involuntary care incidents for clients with challenging behaviour. (2) To explore implementation processes in intellectual disability care by identifying key themes and concerns from the perspectives of care professionals and experts-by-experience. (3) To examine implementation processes through the lens of Normalisation Process Theory and gaining insight into interventions and strategies used to drive social mechanisms of implementation. (4) To evaluate the value of collaboration within Communities of Practice for sharing knowledge and designing implementation plans. (5) To evaluate adaptations made by organisations to tailor the MDET method to their organisational structure and to test effectiveness of the adapted versions of the method. Chapter 2On 1 January 2020, the Care and Coercion Act (CCA) came into effect in the Netherlands. The CCA strengthened the rights of clients with intellectual disabilities to self-determine the nature and form of their care and treatment. A step-by-step plan with multi-disciplinary consultation to evaluate involuntary care practices is part of this new law. Care organisations were given one year to adapt their work processes to the CCA. In practice this meant that care professionals had to be educated about the CCA, and the step-by-step plan they had to follow to evaluate and phase out involuntary care practices. The study described in Chapter 2 tested statistical changes in the amount of recordings of involuntary care during the transition year of 2020 and after full implementation in 2021. The data were taken from the care records of more than 3,000 clients with intellectual disabilities and challenging behaviour (ZZP 6 en 7 of the Dutch allocation system). Two impact moments were examined: the date on which the CCA came into effect (1 January 2020) and the date on which the CCA had to be fully adhered to one year later (1 January