A secure base? The adolescent–staff relationship in secure
residential youth care
Annemiek T. Harder, Erik J. Knorth and Margrite E. Kalverboer
Department of Special Needs Education and Youth Care, University of Groningen, Groningen, the Netherlands
ABSTRACT
The client–therapist relationship is recognized as an important factor
contributing to outcomes of child and youth care. Particularly in
secure residential youth care, in which adolescents with mainly exter-
nalizing behaviour problems are often placed coercively, the client–
staff relationship seems to be important for the achievement of
positive outcomes. The present study aims to assess the client–staff
relationship for a group of 135 adolescents in secure residential care
and factors associated with a positive relationship. The results show
that adolescents, group care workers and teachers experience a
limited affective bond in their relationship 2 months after the ado-
lescents were admitted to the secure care centre. Adolescents do tend
to use care workers and teachers as a secure attachment figure, which
suggests that an affective bond is no precondition for the adolescents
to experience staff as a secure base. Main predictors of a good
relationship are the positive treatment skills of both group care
workers and teachers. These findings point to the need for training of
care workers and teachers so that they are better prepared for
working with these adolescents.
Correspondence:
Annemiek T. Harder,
Faculty of Behavioral and Social
Sciences, Department of Special
Needs Education and Youth Care,
University of Groningen,
Groote Rozenstraat 38,
NL-9712 TJ Groningen,
The Netherlands
E-mail: A.T.Harder@rug.nl
Keywords: adolescence, difficult
behaviour, empirical research,
residential care, secure
accommodation
Accepted for publication: January
2012
INTRODUCTION
An important contributing factor to outcomes of
mental health care is the relationship between clients
and their therapists (Karver et al. 2006).This relation-
ship is most commonly defined as an emotional con-
nection (e.g. affective attachment, affective bond
[AB], social support) and/or a cognitive connection in
terms of agreement on the tasks and goals of therapy
(Karver et al. 2005). Important client factors influenc-
ing the relationship are e.g. the client’s motivation for
and expectations of the treatment (Karver et al. 2005).
Important therapist factors related to the client–
therapist relationship are e.g. a client-centred attitude,
communication and listening skills and self-reflection
(Ackerman & Hilsenroth 2003).
The relationship between clients and therapists
especially seems to be important in the context of
child and youth care, because child and adolescent
clients typically are not self-referred and often enter
into treatment unaware of their problems, resistant to
change and/or in conflict with their parents (Shirk &
Karver 2003; Karver et al. 2006). Particularly in a
secure residential care context, in which adolescents
are usually placed under coercion, the relationship
between clients and therapists seems to be important.
Secure residential care can be defined as the most
intensive type of residential care and refers to a type of
service in which young people receive mandated care
and treatment in a locked facility. Clients in secure
residential care often show a lack of motivation for
treatment (cf. Englebrecht et al. 2008). Moreover,
previous research indicates that there is a strong asso-
ciation between the quality of the client–therapist rela-
tionship and treatment outcomes for young people
with externalizing problems (Shirk & Karver 2003): a
group that is often prominently represented in secure
residential care (Bullock et al. 1990).
doi:10.1111/j.1365-2206.2012.00846.x
1 Child and Family Social Work 2012 © 2012 Blackwell Publishing Ltd