Page 20 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

all this in mind, it was very likely that substance use would occur pervasively among the youngsters admitted to De Fjord. Previous research already indicated that substance use was related to attrition and treatment outcome in youth treated for severe disruptive behavior combined with psychiatric disorders (Boon & De Boer, 2007).
In this light, it has to be noted that in the early days of de Fjord, in the nineties of the previous century, it was generally accepted that substance usage and therapy could not be combined. Therefore, substance usage was initially prohibited and treatment of addiction was primarily aimed at repressing substance use. Not long after, it became clear that many of the orthopsychiatic youngsters had difficulties with substance use and the treatment philosophy became more nuanced and relapse prevention became an important part of the treatment.
Study sample and design or methods
In the beginning, De Fjord was a residential institution for 24 youths. Over the years the facility has expanded with an extra eight clinical “beds” and a department for 20 outpatients. Participants involved in the studies of the present thesis were the youths of the residential departments of De Fjord (age 15.3 – 20.7), and their parents.
All youngsters admitted from the start of the facility in 1995 were approached to participate in the study. According to legislation and the institution’s policy, after a personal description of the study to the subjects, written informed consent (asking for the use of their information for research) was obtained. All youngsters agreed to participate and in concordance with the institutional policy, they participated without receiving incentives or rewards. In the present thesis, data were used of those who had been discharged up to and including 2012 (N=294).
According to the study protocol (Bruinsma & Boon, 2001), measurements were conducted at intake (T0), within the first weeks of admission (T1), in the week prior to discharge (T2) and at follow-up (one year after discharge, T3). Although it was the intention that the follow-up measurements took place one year after discharge, in many cases more time was required to succeed. In some cases, much effort was needed to trace the youngster for the follow-up measurement. All this led to a follow- up that took place on average 18 months after discharge.
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