The effectiveness of Forensic Outpatient Systemic Therapy in the treatment of juvenile antisocial behavior: A study protocol of a Multiple Case Experimental Design.

BACKGROUND: Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, reaching client formulated subgoals, and improving family functioning. Processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning. METHODS: A Multiple Case Experimental Design (MCED) with an ABC design will be performed (A = baseline, B = intervention, and C = follow-up). Juveniles with primary aggression and/or anger problems (N = 15) and their caregiver(s) will be recruited. Data collection will consist of self-report questionnaires and case file analysis. Participants fill out frequent short self-report questionnaires (twice a week during phase A, every other week during phase B, and every week during phase C) and two main questionnaires at the start of the intervention and immediately after intervention end, thereby covering a period of 5 to 11 months. Both visual and statistical analyses will be performed. DISCUSSION: This study will generate robust knowledge and inform clinical practice on the effectiveness, processes of change, and mediating mechanisms of FAST, aiming to improve the treatment of future families within youth forensic care. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on 28/08/2023, protocol ID 60-63600-98-1138a.

Effectiveness of a multidisciplinary treatment with youth-initiated mentoring for youths with mental health needs from multi-problem families: a quasi-experimental study.

BACKGROUND: Children from multi-problem families have an increased risk for experiencing mental health problems. These families face problems in several domains that are often found to be chronic and intergenerational. Yet, the effects of mental health care for youths from multi-problem families are small at best, urging research on new treatment programs. The InConnection approach is an integrated care program to improve resilience of youths with mental health needs from multi-problem families by connecting professional expertise from multiple disciplines with the informal social network of the youth. Youths are asked to nominate a youth-initiated mentor (YIM) from the supportive adults in their network. METHODS: This quasi-experimental study compared the effectiveness of the InConnection approach to treatment as usual in a sample of 107 families (n = 66 intervention group, n = 41 control group) with n = 115 youths receiving treatment (cases). Youths (n = 102 reports, Mage = 15.59 years), parents (n = 85 reports) and case managers (n = 107 reports) responded to questionnaires four times over 15 months. Using these data, we measured youth resilience as the primary outcome, seven secondary outcomes, and three intermediate outcomes. RESULTS: Latent growth models showed only one significant change in outcomes over time across conditions, namely a decrease in case manager-reported child unsafety, and only two condition effects, which were both parent-reported. Parents in the InConnection group reported improvements over time in youth's emotional and behavioral problems and their own positive parenting, whereas control parents reported no changes (ps ≤ 0.013). DISCUSSION: The treatment conditions were not effective in improving most of the youth and parental outcomes over time, except for child safety reported by the case manager. The InConnection approach only outperformed care as usual on two parent-reported outcomes. Future research should examine for whom and under what circumstances the InConnection approach works more convincingly. TRIAL REGISTRATION: Netherlands Trial Register NL7565. Retrospectively registered on 05/03/2019.

The effectiveness of blended versus regular Forensic Outpatient Systemic Therapy in the treatment of juvenile antisocial behavior: a study protocol of a randomized controlled trial.

BACKGROUND: Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12-21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. METHODS: A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) or FASTr (n = 100). Data collection will consist of self-report questionnaires and case file analysis, and include a pre-test at the start of the intervention, a post-test immediately after the intervention, and a six month follow-up. Mechanisms of change will be investigated using monthly questionnaires of key variables during treatment. Official recidivism data will be collected at two-year follow-up. DISCUSSION: This study aims to improve the effectiveness and quality of forensic mental health care for juveniles with antisocial behavior by studying the effectiveness of blended care, which has not been studied before in treatment of externalizing behavior. If found to be at least as effective as face-to-face treatment, blended treatment can help meet the urgent need for more flexible and efficient interventions in this field. In addition, the proposed study aims to unravel what works for whom, knowledge urgently needed in mental health care for juveniles with severe antisocial behavior. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on 07/11/2022, registration number NCT05606978.

The Effectiveness of School-Based Skills-Training Programs Reducing Performance or Social Anxiety: Two Randomized Controlled Trials.

Background: Given that high levels of stress during adolescence are associated with negative consequences, it is important that adolescents with psychological needs are supported at an early stage, for instance with interventions at school. However, knowledge about the potential of school-based programs targeting adolescents with psychological needs, aimed at reducing school or social stress, is lacking. Objective: The current study aimed to investigate the effectiveness of two targeted school-based skills-training programs, addressing either skills to deal with performance anxiety or social skills. Methods: Two randomized controlled trials were performed with participants who self-selected to one of the programs. The sample comprised of N = 361 adolescents (M age = 13.99 years, SD = 0.83) from various educational levels and ethnic identity backgrounds. The performance anxiety program included N = 196 participants (N = 95 in the experimental group), while the social skills program included N = 165 participants (N = 86 in the experimental group). MANCOVA's were performed. Results: The performance anxiety program had a small effect on reducing adolescents' test anxiety. Furthermore, for adolescents who attended more than half of the sessions, the program had small effects on reducing test anxiety and fear of failure. The program did not improve adolescents' coping skills or mental health. The social skills program was not effective in improving social skills, social anxiety, and mental health. Conclusions: A relatively short, targeted program addressing skills to deal with performance anxiety can have the potential to reduce adolescents' performance anxiety. Trial registration: International Clinical Trials Registry Platform (Netherlands Trial Register, number NTR7680). Registered 12 December 2018. Study protocol van Loon et al., (2019). Supplementary Information: The online version contains supplementary material available at 10.1007/s10566-023-09736-x.

Ramping Up Detention of Young Serious Offenders: A Safer Future?

When youth commit serious violent or sexual offenses, this often generates a call for more severe punishments and longer detention sentences. An important question is whether (long) detention sentences are effective in decreasing recidivism among serious young offenders. To estimate recidivism rates in serious young offenders and elucidate the link between sentencing (in terms of custodial vs. non-custodial and length of imprisonment) and recidivism, three multilevel meta-analyses were conducted. With a systematic literature search, 27 studies and four datasets were traced, involving N = 2,308 participants, yielding 90 effect sizes for overall recidivism, 24 for specifically violent recidivism, and 23 for the association between length of imprisonment and recidivism. The average weighted overall recidivism rate was 44.47% (95% confidence interval [CI]: 37.59-51.46%) over an average period of 8.68 years. The rate of violent recidivism was estimated at 30.49% (95% CI: 20.92-40.52%), over an average period of 11.45 years. Recidivism rates were higher when recidivism was defined as an arrest for any new offense rather than for a specific offense and in studies conducted in the United States versus European studies. Violent recidivism rates were higher in studies with longer follow-up periods. Based on the limited available studies, no difference in recidivism rates following custodial and non-custodial sentences were found, nor an association between length of imprisonment and recidivism. To increase rehabilitation chances for youth offenders, further research is warranted to better understand the impact of sentencing and to ascertain what is needed to make custodial and non-custodial sentences more effective.

Resilience, well-being and informal and formal support in multi-problem families during the Covid-19 pandemic.

BACKGROUND: The Covid-19 pandemic may have had negative effects on youth and parental mental health, especially in high-risk populations such as multi-problem families (i.e., families that experience problems in multiple domains, such as mental health and social network problems). Using one to four assessments during all phases of the Covid-19 pandemic up until January 2022, we examined the associations between pandemic-related stress and mental health (resilience and well-being) of youth and parents from multi-problem families. We also investigated whether experienced informal (i.e., youth informal mentoring) and formal support (i.e., therapist support) served as protective factors in this association. METHODS: A total of 92 youth aged 10-19 years (46.7% girls; mean age 16.00 years) and 78 parents (79.5% female; mean age 47.17 years) filled in one to four questionnaires between March 2020 and January 2022. Multi-level analyses were conducted to account for the nested structure of the data. RESULTS: For youth, pandemic-related stress was associated with lower well-being, but not with resilience. Perceived support from both mentors and therapists was positively associated with youth mental health. Furthermore, high perceived therapist support protected youth from the negative effect of pandemic-related stress on resilience. For parents, pandemic-related stress was not related to mental health, irrespective of therapist support. Yet, therapist support was directly and positively associated with parental mental health. CONCLUSIONS: Youth from multi-problem families who experience pandemic-related stress are at risk of (elevated) mental health problems during the pandemic, specifically if they have no or weak therapist support. The mental health of parents, however, was minimally affected by pandemic-related stress, indicating strength and flexibility. Youth and parents who experienced support during the pandemic reported higher levels of resilience and well-being, demonstrating the importance of support for individuals' mental health during stressful times such as a pandemic.

Trajectories of adolescent perceived stress and symptoms of depression and anxiety during the COVID-19 pandemic.

Adolescents might be particularly affected by the drastic social changes as a consequence of the COVID-19 pandemic, given the increased stress-sensitivity and importance of the social environment in this developmental phase. In order to examine heterogeneity during the pandemic, the current study aimed to identify whether subgroups of adolescents could be distinguished based on their levels of perceived stress and symptoms of depression and anxiety. In addition, we examined which prepandemic factors predicted these trajectories. Adolescents were assessed before the pandemic (N = 188, Mage = 13.49, SD = 0.81) and at three timepoints during the pandemic (i.e., eight, ten, and 15 months after the start of the pandemic in the Netherlands). Results showed no support for distinct trajectories of perceived stress, adolescents experienced stable moderate levels during the pandemic. In contrast, results showed three trajectories for depression and anxiety. The majority of adolescents reported stable low or moderate levels and one small subgroup reported high levels of depression and anxiety that decreased during the pandemic. Certain prepandemic factors predicted higher initial levels of stress and symptoms of depression and anxiety during the pandemic. To support adolescents with prepandemic vulnerabilities, strategies could be developed, for instance enhancing adolescents' social support.

A Friend in Prison: Human-Animal Bond, Stress and Self-Esteem of Detained Juveniles in Dutch Cell Dogs.

This study examined to what extent the human-animal bond (HAB) had a positive impact on stress and self-esteem among detained juveniles participating in the prison-based dog training program Dutch Cell Dogs (DCD). Participants were 75 detained juveniles (mean age = 19.5, 86.7% male). Self-reported stress and self-esteem were assessed before the start of DCD (T1), after four weeks (halfway training/T2) and after eight weeks (end training/T3). Structured interviews and questionnaire items were used to measure the HAB quality and perceived reciprocity in the HAB at T2 and T3. Data were analyzed using Structural Equation Modeling. In the variable-centered approach analyses, only the cross-sectional positive association between HAB quality and self-esteem at T2 was significant in the cross-lagged panel models. None of the cross-lagged paths between the HAB and stress or self-esteem were significant. In the person-centered approach analyses, growth mixture modeling identified two patterns of self-esteem ("high stable" and "high decreasing"); however, these patterns were not predicted by HAB. Thus, in contrast to our hypotheses, the HAB did not predict improvements in detained juveniles' stress and self-esteem. These findings underline the need for more research into the often-presumed role of HAB within prison-based dog training programs.

The effects of school-based interventions on physiological stress in adolescents: A meta-analysis.

Chronic stress is associated with dysregulations in the physiological stress system, resulting in diverse negative developmental outcomes. Since adolescence is a period characterized by increased stress-sensitivity, and schools are an important environment for the developing adolescent, school-based interventions promoting psychosocial functioning are of particular interest to prevent adverse outcomes. The present study therefore aimed to investigate the effectiveness of such interventions on hypothalamic pituitary adrenal-axis (i.e., cortisol) and cardiovascular (i.e., blood pressure [BP] and heart rate [HR]/heart rate variability [HRV]) parameters of stress in adolescents, and examined moderators of effectiveness. The search resulted in the inclusion of k = 9 studies for cortisol, k = 16 studies for BP, and k = 20 studies for HR/HRV. The results indicated a significant small overall effect on reducing BP, but no significant effect for HR/HRV. For cortisol, large methodological variation in the few primary studies did not allow for quantitative analyses, but a qualitative review demonstrated inconsistent results. For BP and HR/HRV, larger effects were observed for intervention programs with a mindfulness and/or meditation component, for interventions without a cognitive-behavioural component and for interventions with a higher intensity. Providing adolescents with techniques to improve indicators of physiological stress may prevent emerging mental health problems.

Heart-wired to be cold? Exploring cardiac markers of callous-unemotional traits in incarcerated offenders.

Elevated callous-unemotional (CU) traits have been repeatedly identified in a subgroup of offenders that displays severe antisocial behavior; establishing physiological markers may help improve early identification and treatment efforts. This study examines to what extent baseline-resting heart rate (HR) and heart rate variability (HRV) can be used as markers of CU in incarcerated juvenile and adult offenders. CU traits were assessed using the Inventory of Callous-Unemotional traits. Results of the multiple hierarchical regression tests indicated that there was a small yet significant positive association between baseline HR and CU and negative association between HRV and CU in juvenile offenders with medium model effect sizes (R2 = 0.115 for HR-CU; R2 = 0.126 for HRV-CU). The cardiac markers were unrelated to CU in adult offenders. These findings are important because they demonstrate that impaired cardiac autonomic activity is related to CU traits in juveniles, suggesting that socioemotional processing difficulties should be considered in understanding these deficits. Future research should be conducted in large samples, under reactive and static conditions, while including cardiac covariates, to get more clarity on the interplay between biological systems and behavioral expression.

Prepandemic Risk Factors of COVID-19-Related Concerns in Adolescents During the COVID-19 Pandemic.

To identify adolescents who may be at risk for adverse outcomes, we examined the extent of COVID-19-related concerns reported by adolescents and investigated which prepandemic risk and protective factors predicted these concerns during the COVID-19 pandemic. Dutch adolescents (N = 188; Mage  = 13.49, SD = .81) were assessed before the pandemic and at eight and ten months into the pandemic. Results demonstrated that adolescents' most frequently reported COVID-19-related concerns were about social activities and getting delayed in school. Adolescents that have specific vulnerabilities before the pandemic (i.e., higher stress, maladaptive coping, or internalizing problems) experience more concerns during the pandemic, stressing the importance of guiding and supporting these adolescents in order to prevent adverse developmental outcomes.

A Quasi-Experimental Study on the Effectiveness of Dutch Cell Dogs in Incarcerated Youth.

This study examined the effectiveness of Dutch Cell Dogs (DCD), a prison-based dog training program that aims to improve socioemotional functioning of incarcerated youth by giving them the opportunity to train a shelter dog. Primary (aggression and institutional infractions) and secondary (wellbeing and therapeutic functioning) outcomes were assessed for the intervention (n = 61) and comparison group (n = 77) before the start of DCD, after 4 weeks, and after 8 weeks at posttest. Overall, DCD participation was not effective. Compared to the comparison group, institutional infractions decreased in DCD participants with an immigrant background and increased in DCD participants with a native Dutch background. In addition, DCD participation reduced the quality of the therapeutic alliance for younger participants and those in secure residential facilities. The current study demonstrated heterogeneity in DTP responsiveness. Future research with robust designs and sufficiently large samples is needed to further identify who benefits from DTPs.

Brief report: The effectiveness of Dutch Cell Dogs: A multiple case experimental study.

Prison-based dog training programs (DTPs) aim to improve successful rehabilitation after detention. However, empirical evidence for their effectiveness is lacking. To evaluate the effectiveness of a DTP-Dutch Cell Dogs (DCD)-on externalizing behavior, stress, self-esteem, empathy, and treatment motivation, a pilot study with a Multiple Case Experimental Design in six adolescents residing in a juvenile justice center (JJC) was conducted. Results did not provide convincing evidence for DCD's effectiveness. Further research is needed to determine whether and for whom DCD could be a useful addition to regular JJC programming.

Effectiveness and working mechanisms of the InConnection approach in multi-problem families: study protocol of a mixed-methods study.

BACKGROUND: Multi-problem families face problems in several domains that are often found to be chronic and intergenerational. Effective mental health care for youth from these families is currently lacking, urging research on new methods. The InConnection approach is an integrated care program to improve resilience in multi-problem families by connecting the professional expertise from multiple disciplines with the informal social network of the youth. Specifically, youth are asked to nominate a youth initiated mentor (YIM) from among the supportive adults in their network. The aim of this protocol is to describe the design of a mixed-methods study to examine the effectiveness and working mechanisms of the InConnection approach. METHOD/DESIGN: The effectiveness of the InConnection approach is studied in a quasi-experimental questionnaire study using propensity score matching, with N = 300 families with youth aged 10-23 years receiving treatment in either the intervention group (InConnection approach) or the control group (care as usual). The main outcome variables include youth resilience (primary), youth mental health, parental functioning, and the number, duration and types of out-of-home placements. Mediators, moderators, and predictors of effectiveness are examined. Assessments take place at the start of the care program and after three, nine and 15 months. Additionally, semi-structured interviews are conducted with families who have and have not nominated a YIM to understand why some families successfully nominate a YIM, whereas others do not. DISCUSSION: Effective care for youth in multi-problem families is urgently needed. Given its flexibility and accessibility to suit all youth aged 10-23 years from multi-problem families, and its low costs compared to out-of-home placements, the InConnection approach seems an appealing approach to support these families. The current study will provide information on the effectiveness of the InConnection approach. Strengths of this study include its robust design, the ecological validity, and the inclusion of possible mediators, predictors, and moderators of treatment effects. TRIAL REGISTRATION: Netherlands Trial Register NL7565 . Retrospectively registered on March 5, 2019.

Can Schools Reduce Adolescent Psychological Stress? A Multilevel Meta-Analysis of the Effectiveness of School-Based Intervention Programs.

Increased levels of psychological stress during adolescence have been associated with a decline in academic performance, school dropout and increased risk of mental health problems. Intervening during this developmental period may prevent these problems. The school environment seems particularly suitable for interventions and over the past decade, various school-based stress reduction programs have been developed. The present study aims to evaluate the results of (quasi-)experimental studies on the effectiveness of school-based intervention programs targeting adolescent psychological stress and to investigate moderators of effectiveness. A three-level random effects meta-analytic model was conducted. The search resulted in the inclusion of k = 54 studies, reporting on analyses in 61 independent samples, yielding 123 effect sizes (N = 16,475 individuals). The results indicated a moderate overall effect on psychological stress. Yet, significant effects were only found in selected student samples. School-based intervention programs targeting selected adolescents have the potential to reduce psychological stress. Recommendations for practice, policy and future research are discussed.

The effectiveness of school-based skills-training programs promoting mental health in adolescents: a study protocol for a randomized controlled study.

BACKGROUND: Adolescence is a period of elevated stress sensitivity, which places adolescents at increased risk of developing mental health problems such as burnout, depression, anxiety, and externalizing problems. Early intervention of psychological needs and low-threshold care addressing such needs may prevent this dysfunctional development. Schools may provide an important environment to identify and address psychological needs. The aim of this protocol is to describe the design of a study aiming to evaluate the effectiveness of low-threshold school-based skills-training programs promoting the mental health of adolescents and to examine moderators of the effectiveness. METHODS: A Randomized Controlled Trial will be conducted to examine the effectiveness of two school-based skills-training programs aiming to promote mental health by improving either skills to deal with performance anxiety or social skills. A multi-informant (i.e., students, parents, and trainers) and multi-method (i.e., questionnaires and physiological measurements) approach will be used to assess program targets (skills to deal with performance anxiety or social skills), direct program outcomes (performance or social anxiety) and mental health outcomes (i.e., stress, internalizing and externalizing problems, self-esteem and well-being), as well as specific moderators (i.e., student, parent and program characteristics, social support, perfectionism, stressful life events, perceived parental pressure, positive parenting behavior, treatment alliance and program integrity). DISCUSSION: The current study will provide information on the effectiveness of school-based skills-training programs. It is of crucial importance that the school environment can provide students with effective, low-threshold intervention programs to promote adolescents' daily functioning and well-being and prevent the emergence of mental health problems that negatively affect school performance. TRIAL REGISTRATION: Dutch Trial Register number NL7438 . Registered 12 December 2018.

A Randomized Controlled Trial on the Effectiveness of Family Group Conferencing in Child Welfare: Effectiveness, Moderators, and Level of FGC Completion.

The present study examined the effectiveness of Family Group Conferencing (FGC) in child welfare. Effects were operationalized in terms of child safety (child maltreatment, supervision order, and out-of-home placement), number of professional services used, parental empowerment, and social support in a 1-, 3-, 6-, and 12-month follow-up. Furthermore, the influence of family characteristics and the level of FGC completion were examined. A total of 328 families were included, randomly assigned to an experimental group ( n = 229) and a care as usual (CAU) group ( n = 99). FGC was equally effective as CAU in improving child safety but resulted in more out-of-home placements. Furthermore, FGC resulted in a longer duration of child welfare involvement, a marginally higher number of professional services used, and increased parental empowerment and social support. Family characteristics did not moderate the results. Level of FGC completion was in general low. Higher levels of completion were related to a larger social network, a higher number of professional services used, and, marginally, less parental empowerment. In conclusion, although some beneficial results marginally support the use of FGC, it is the question whether these effects outweigh FGC costs, a longer duration of child welfare involvement and a higher number of professional services used.

Cost-effectiveness of Family Group Conferencing in child welfare: a controlled study.

BACKGROUND: This study aimed to examine the short- and long term (cost-) effectiveness of Family Group Conferencing (FGC) compared to care as usual (CAU) in terms of improved child safety, empowerment and social support. METHODS: A subgroup of a larger randomized controlled trial, comprising 69 families in child welfare (experimental group: n = 46; control group: n = 23), was included. RESULTS: No additional effects of FGC on child safety, social support and only short-term positive effects on empowerment were found. There were no differences in costs between FGC and CAU. The chance for FGC to be cost-effective was small. For families who refused FGC, the FGC approach was more cost-effective than CAU, whereas it was less cost-effective for families that prepared or completed FGC. CONCLUSIONS: Overall, FGC is not (cost-)effective in improving child safety, empowerment and social support, but cost-effectiveness varies at different levels of FGC-completion. TRIAL REGISTRATION: Dutch Trial Register number NTR4320 . Registered 17 December 2013.

The effectiveness of Dutch Cell Dogs in correctional facilities in the Netherlands: a study protocol of a quasi-experimental trial.

BACKGROUND: Many former inmates recidivate, resulting in high costs for societies worldwide. Evidence based treatment practices may not work in prisons, due to detainees' lacking motivation, impaired well-being, and an unsafe group environment. One attempt to improve social group climate and well-being is the use of Prison-based Animal Programs (PAP). Using a quasi-experimental design, the aim of the current study is to examine the effectiveness of one such PAP in the Netherlands: Dutch Cell Dogs (DCD). METHODS/DESIGN: Participants (N = 256) from 12 justice centers, including psychiatric, juvenile and adult facilities, will be recruited. Half of the sample (n = 128) will receive DCD training after voluntarily signing up (intervention group); The other half (n = 128) will be recruited to participate in the research and receive treatment-as-usual (TAU/Ccomparison group). Factors related to psychosocial functioning (e.g., self-esteem, empathy, self-control, life satisfaction, attention) and general therapeutic factors (i.e., therapeutic alliance, treatment motivation), expected to contribute to treatment success, will be assessed to measure the effectiveness of DCD. In addition, behavioral problems will be measured as well as recidivism rates. Questionnaires and neuropsychological tests will be employed to measure aforementioned outcome variables. Moreover, physiological data, based on heart rate and cortisol measures, will be collected to provide insight into the functioning of participants' physiological stress response and to determine whether stress reduction occurs over time. Multimethod data collection will occur at pre-training (T1), at 1-month (halfway training/T2), at 2-months (end training/T3), and 6-months after the end of the training (follow up/T4). DISCUSSION: This is the first study to examine the effectiveness of a widely implemented PAP in the Netherlands. Challenges associated with conducting the proposed study are typical for practice based research in correctional settings (e.g., a demanding workload of staff, lack of motivation to participate in research). Study results on the effects of a PAP will have an impact on inmates, justice centers, and municipalities across the Netherlands. TRIAL REGISTRATION: Retrospectively registered. The Netherlands National Trial Register TC = 6894 .

Alcohol use of immigrant youths in The Netherlands: The roles of parents and peers across different ethnic backgrounds.

INTRODUCTION AND AIMS: The aims of this study were to examine the roles of parental permissiveness toward alcohol use and affiliation with alcohol-using peers in alcohol use in youths from various ethnic backgrounds, and whether the role of peers was moderated by parental permissiveness. In addition, differences in these associations between native Dutch and non-Western immigrant youths were examined. DESIGN AND METHODS: Cross-sectional data of 578 youths with Surinamese, Moroccan, Turkish, Antillean and Asian backgrounds and 81 native Dutch were used, all aged 15-24. Alcohol use, affiliation with alcohol-using peers and parental permissiveness were measured using self-report questionnaires. Regression models controlled for age, religiousness, education level and parental alcohol use. Because of very low levels of alcohol use, data from Turkish and Moroccan immigrants were aggregated, and logistic regression analyses were performed. RESULTS: Parental permissiveness and affiliation with alcohol-using peers were positively related to level of alcohol use in youths with Surinamese, Antillean and Asian backgrounds and played an equally strong role in native Dutch youths with one exception. In Surinamese youths, parental permissiveness was more strongly related to alcohol use than in native Dutch youths. In youths with a Turkish/Moroccan background, parental permissiveness and affiliation with alcohol-using peers were strongly associated with any (versus no) alcohol use. Only parental permissiveness was, equally strong, associated with any alcohol use in native Dutch youths. DISCUSSION AND CONCLUSIONS: Irrespective of ethnic background and differences in level of alcohol use, parental permissiveness and affiliation with alcohol-using peers are related to youth alcohol use. [Creemers HE, Spanakis P, Delforterie MJ, Huizink AC. Alcohol use of immigrant youths in The Netherlands: The roles of parents and peers across different ethnic backgrounds.