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General introduction 211remained a challenge for many care providers. Research conducted by the Dutch Health Care Inspectorate in 2007 and 2008 indicated that care organisations were still applying restrictive measures (IGZ, 2008). In response, at a conference on November 18, 2008, care organisations and the Inspectorate signed the %u201cCare for freedom%u201d declaration committing to reduce restrictive measures as much as possible. In 2010 the Inspectorate concluded that with organised national programmes and strategies to improve freedom for clients, restrictive measures could in some cases easily be reduced (IGZ, 2009, 2010, 2011).Against this background, in 2011, the Netherlands was startled by a television broadcast concerning a client with an intellectual disability being tethered to a wall, and the news in the following weeks that in care organisations, approximately 40 clients with intellectual disabilities and extreme forms of challenging behaviour were severely restricted, through seclusion, restraint and sedation (Frederiks, 2011). The need for phasing out involuntary care and restrictive measures was felt not only in long-term care organisations but also by the government and in the entire Dutch society (Denktank Complexe Zorg, 2012). The focus of treatment, care, and support for people with intellectual disabilities shifted towards interventions and methods guiding care professionals in prioritising and addressing clients%u2019 basic physical, emotional, and psychological needs (Maslow, 1943; Ryan & Deci, 2000) instead of focusing on minimising challenging behaviour through restrictive measures. An open trial of the Dutch values-driven Triple-C treatment model (Tournier et al., 2020) among 47 clients with intellectual disabilities concluded that addressing clients%u2019 needs in care may account for the observed improvement in adaptive skills, quality of life, and reduction in challenging behaviour and restrictive measures (Van Wouwe et al., 2013). The enactment of the Care and Coercion Act in 2020 has further propelled efforts to align with clients%u2019 needs and preferences for care and support. The CCA has adopted a broad definition of involuntary care: %u2018Any care opposed by a client or client-representative%u2019 (Staatsblad, 2018). In practice this means that all curtailment of the right to self-determination is considered involuntary care. This includes both %u201cminor%u201d and %u201cmajor%u201d restrictions. Minor restrictions are, for example, not being able to make one%u2019s own decisions,