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Summary2098Chapter 6 The Multi-Disciplinary Expertise Team (MDET) method was developed to reduce involuntary care in long-term care for people with intellectual disabilities. In a previous study, MDET was found to be effective in increasing the reduction of involuntary care compared to usual care. MDET is a multi-component method in which MDET-experts give advice on phasing out involuntary care in care teams working with clients with intellectual disabilities. MDET-experts are care professionals with different backgrounds working in the organisation with expertise in phasing out involuntary care measures. They were brought together by a MDET coordinator to form an independent MDET-expert team. The method has three core components: (1) inventory and recording of all applied forms of involuntary care, (2) a consultation plan for phasing out involuntary care for individual clients, and (3) advising on changes at the team level to recognise and reduce involuntary care. The protocol for MDET follows a series of six consecutive phases: preparation, start, plan, action, completion and follow-up The study in Chapter 4 examined how four care organisations adapted MDET from the original version during implementation and tested whether these adapted versions also increased reduction of involuntary care. To assess adaptations interviews with MDET-coordinators were analysed. An interrupted time-series design tested change in weekly counts of involuntary care recordings from before to during MDET implementation, in care homes that implemented MDET (n = 24) compared to care homes providing care-as-usual (CAU) (n = 24). Adaptations to MDET varied per organisation. These included involving less people in discussing involuntary care, implementing MDET without an independent MDET-team, and loosening recording of involuntary care. No differential changes in recordings of involuntary care were found between the care homes that implemented MDET and the care homes that provided care as usual. To conclude, implementing MDET in other organisations led to adaptations that may have undermined its effects on reducing involuntary care. However, the differences between the old Special Admission Act that was valid during the previous trial and the new Care and Coercion Act that was valid during the current study may also be an explanation for the fact that MDET was not found to be effective.