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Research concerning the implementation of Life Space Crisis Intervention and a multi-level token economy system

Research concerning the implementation of Life Space Crisis Intervention and a multi-level token economy system. Ilse Goethals Eline Spriet. Population . Adolescents with EBD in Flanders (D’Oosterlinck et al., 2006) DSM IV diagnose ‘attention deficit hyperactive disorder’ (ADHD),

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Research concerning the implementation of Life Space Crisis Intervention and a multi-level token economy system

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  1. Research concerning the implementation of Life Space Crisis Intervention and a multi-level token economy system Ilse Goethals Eline Spriet

  2. Population • Adolescents with EBD in Flanders (D’Oosterlinck et al., 2006) • DSM IV diagnose • ‘attention deficit hyperactive disorder’ (ADHD), • ‘conduct disorder’ (CD), • ‘pervasive developmental disorder’ (PDD), • problems related to physical or sexual abuse, • ‘other disorders of infancy, childhood and adolescence’ such as ‘separation anxiety disorder’ and ‘reactive attachment disorder’. • CBCL (Child Behavior Checklist) • High levels of externalising and internalising problem behaviour (aggression) and a lack of social competences D’Oosterlinck, F., Broekaert, E., De Wilde, J., Bockaert, L.F. & Goethals, I. (2006). Characteristics and Profile of Boys and Girls with Emotional and Behavioural Disorders in Flanders Mental Health Institutes: A Quantitative Study. Child: Care, Health and Development, 32 (2), 213-224

  3. Teachers and other staff-members (n=26) Average age: 41 Gender female = 20 % male = 80 % years of employment 1 - 12 years = 61 % 13 - 24 years = 26 % 25 - 37 years = 13 % Educators and other staff-members (n = 38) Average age: 41 Gender female = 54 % male = 46 % years of employment 1 - 12 years = 58 % 13 - 24 years = 5 % 25 - 37 years = 37 % School Home

  4. Research aims of the project 2006 - 2008 • 2006 • Aim 1: detect specific problem areas • Aim 2: develop a test-battery to objectify the problem areas • 2007 • Aim 3: evaluate the implementation of LSCI and the token economy level-system • Aim 4: follow-up 2007 • 2008 • Aim 5: follow-up 2008

  5. Aim 1: Detect problem areas • Method • Instruments • Observations in class-rooms and in the living-groups • Analysis of documents • Unstructured conversations • Subjects: • Youngsters • Teachers • Educators • Staff-members • External partners • Analysis • All interviews were tape-recorded and transcribed • Content analysis with a qualitative software package (WinMAX). • Coding hermeneutic units by two groups • Tree-structure of categories and subcategories

  6. Results • Main problem areas • Cooperation between school and the home • Not enough support • Feeling of insecurity • High amount of Truancy • Disruptive behaviour • Conflicts between youngsters

  7. Aim 2: Objectify problem areas Dawson, C. A. (2001). Crisis Intervention Training and Support for School Staff of Junior High School Special Education Students Emotional Disturbances. Unpublished dissertation. Nova South-Eastern University, Florida, U.S.A. D’Oosterlinck, F., Goethals, I., Broekaert, E., Schuyten, G., De Maeyer, J. (2008). Implementation and effect of life space crisis intervention in special schools with residential treatment for students with emotional and behavioral disorders (EBD). Psychiatric Quarterly, 79(1), 65-79.

  8. Aim 2: objectify problem areas • Method • Instruments • Administrative registrations • Self-report scales • Surveys • Administrative registrations during 22 days (April-May) • Truancy • suspensions • Transfers to more or less restrictive settings

  9. Instruments (2) • Administrative registrations • Conflicts • time and place of conflict • people involved • nature of the conflict according to LSCI • Critical incidents • Verbal aggression • Physical aggression • Complaint of parents • Nursery visits because of fight • Access to bus was denied • Police interference • To buzz a staff member during the weekend

  10. Instruments (2) • Self-report scales • YSR (Youth Self Report; 11 to 18 years) • measuring problem behaviour • Main scales • Internalising behaviour • Externalising behaviour • Total Problem Behaviour • MASC (Multidimensional Anxiety Scale for Children; 11 to 19 years) • measurements of dimensions of anxiety • Main scales: • Physical symptoms • Harm avoidance • Social anxiety • Separation anxiety • Total anxiety

  11. Instruments (2) • BDHI-D (Buss-Durkee Hostility Inventory - Dutch) • Measurement of aggression and hostility • Indirect aggression • Direct aggression • Social desirability

  12. Instruments (2) • Surveys • CBCL (Child behaviour Checklist) • rated by educators concerning the boys in their living-group • TRF (Teacher Report Form) • rated by teachers concerning their students • Safety on the job • Self-developed questionnaire • 6 statements level of feeling insecure due to: • Delinquent behaviour • Deviant behaviour • Verbal assault • Physical assault • Criminal offences • Insufficient support and recognition • Rated by teachers and educators (n = 64) • 5pt Likert-scale: (very low– very high)

  13. Results: Safety on the job • Most employees feel very insecure because of the verbal assaults of youngsters • Teachers experience higher levels of insecurity as a result of delinquent and aggressive behaviour, when compared to educators • Men, more than women, experience high levels of insecurity due to verbal assaults, aggressive and out of bound-behaviour of youngsters • ‘Age’ and ‘years of employment’ is not specifically related to high or low levels of insecurity

  14. Aim 3: LSCI & Level-Systemevaluation of the implementation

  15. Method • Self-developed survey • 20 statements • Knowledge and use of LSCI • Knowledge and use of Level-System • Example: “I understand how a youngster can move from level 1 to level 2” • Crisis management team • Rating scale: ‘yes’, ‘no’, sometimes’

  16. Result: • Most respondents (70%) • have sufficiant knowledge on how to implement the Level-System • are un-afraid to confront a youngster when he has lost points for inappropriate behaviour • agree that an LSCI conversation can help the youngster • support the basic assumptions of LSCI • are pleased with the crisis team during school ours • 70% of the respondents state they: • are not having LSCI conversations with youngsters who lost points due to inappropriate behaviour • have insufficient knowledge about the rewards per level • are unhappy with the crisis team (residential) • do not register LSCI conversations • have little knowledge on how to organise the follow-up of youngsters who are in level 4 • need more support to implement LSCI

  17. Aim 4: follow-up 2007 Test-battery: Administrative registrations Self-report scales survey

  18. Results: Administrative registrations

  19. Results: Administrative registrations • Number of suspensions: • 2006 = 3 • 2007 = 2 • Number of transfers to more restricted settings: • 2006 = 1 • 2007 = 0

  20. Results: Administrative registrations

  21. Place and time in 2006: Most conflicts occurred: during classes (24%), other situations (17%) at the play area (13%) At the beginning of the week (60%) due to problems with other peers (59%) and/or due to problems with rules and boundaries (42%) and/or problems related with negative self image (38%) and/or Problems with adults (32%)(teachers/educators) Place and time in 2007: Most conflicts occurred: at the play area (29%), during meals (19%), during their free-time (17%) at the end of the week (42%) due to problems with other peers (69%) and/or problems related with negative self image (15%) and/or due to problems with rules and boundaries (11%) and/or Problems with adults (11%) (teachers/educators) Results: Administrative registrations

  22. Results: Administrative registrations • Number critical incidents • 2006: n = 147 • 2007: n = 65 • Significant results: • Day of the week: X²=16,3; p<0,001 • In 2007, critical incidents occurred most at the end of the week (41%) whilst in 2006 most incidents occurred in the beginning of the week (60%) • School year: X²=7,92; p<0,05 • In 2007, most incidents arose in the 1st and 2nd school year (53%) compared to 2006 (43%) • Type of critical incident: X²=23,38; p<0,001

  23. Results: Administrative registrations

  24. Results: YSR/CBCL/TRFAverage ‘Internalising problem behaviour’

  25. Results: YSR/CBCL/TRFAverage ‘Externalising problem behaviour’

  26. Results: YSR/CBCL/TRFAverage ‘Total problem behaviour’

  27. Results: MASCAverage anxiety

  28. Results: BDHI-D hostility and aggression

  29. Aim 5: follow-up 2008

  30. Results: YSR/CBCL/TRFAverage ‘Internalising problem behaviour’

  31. Results: YSR/CBCL/TRFAverage ‘Externalising problem behaviour’

  32. Results: YSR/CBCL/TRFAverage ‘Total problem behaviour’

  33. Results: MASCAverage anxiety

  34. Results: BDHI-Dhostility and aggression

  35. Discussion • Administrative data 2008 will be collected in May and June • Limitations of this research: • No experimental design • No control on administrative registration • No assurance on quality of LSCI conversations • Self-report scales and social desirable answers

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