Page 13 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

disorders with emphasis on prevention during childhood. In case of De Fjord, it 1 entailed a definition that did not explicitly focus on prevention. Orthopsychiatric treatment focusses on youth with psychiatric disorders combined with severe disruptive behavior, in a firmly structured environment.
Initially, De Fjord had been granted an experimental status for five years and had to acquire subsistence rights. Therefore, from the opening in November 1995, program evaluation research was performed to gain insight into characteristics of the population of the facility and into intervention outcome. The research questions concerned were: whether the sample met the predefined characteristics (e.g., previously being treated elsewhere, having both psychiatric problems and disruptive behavior), to what extent treatment goals were attained, and what the psychosocial functioning of the former inpatients was in the year after discharge (follow-up). This initial evaluation led to a report on which basis De Fjord was granted structural funding by the Ministry of Health (Bruinsma & Boon, 2001).
After the justification of its existence, the research at De Fjord continued, because it proved to generate valuable knowledge about the target group. Research data already available since 1995 was extended, although the focus of the research changed. Beside maintaining the existing research questions, the research specifically aimed at differentiation within the inpatient group.
Differentiation: age of onset of the disruptive behavior
The psychiatric disorders as well as the disruptive behaviors of the youngsters treated at De Fjord were diverse, and therefore resulted in a heterogeneous sample. Previous research among a subsample (n=65) indicated that although many individuals seemed to benefit from the treatment, there was a group that performed poorly (Bruinsma & Boon, 2001). About one third of the subsample had terminated treatment prematurely (withdrawal 15.4%, expulsion 18.5%), indicating that for part of them the treatment did not even start. This finding stimulated further research into differentiation of the sample, in order to be able to identify the non-responding group at an early stage. The question even arose whether this group was treatable, or whether other treatment was designated. If it were possible to identify this group in
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