Marianne Welmers

General Introduction 11 CHAPTER 1 Home-Based Family Treatment: Key Service in Youth Care Most children and adolescents are functioning well, growing up in families that foster a stimulating environment helping them to thrive. However, annually about 9% of youth younger than 23 years old in theNetherlands receive some formof professional treatment because of developmental, behavioral, or mental health problems and risks (CBS, 2020). As in many other countries, public policy in the Netherlands aims at providing youth care “as at home as possible”, assuming that professional help for children at risk is most effective and efficient when it aims at empowering the family and is provided in their own environment (Lee et al., 2014; Rijksoverheid, 2021). Given these policy principles, it may not be surprising that home-based family treatment (HBFT) is the most provided service in youth care (CBS, 2020; Child Welfare Information Gateway, 2014; Yorgason, 2005). HBFT is generally provided to a highly heterogeneous population of families in terms of demographic features and presenting problems. In general, families receiving HBFT typically experience persistent problems in child behavior or mental health, parenting skills, and family interactions (Assen et al., 2020). These child and parenting problems have often accumulated with problems in other domains, such as parent mental health, parent substance abuse, poverty, or the lack of a supporting social network (Assen et al., 2020; Visscher, 2020). Involvement in HBFT can be either voluntary or mandated by court order. Either way, engagement in treatment is often challenging, as many families have had prior negative experiences with professional care (Bodden & Deković, 2016). HBFT includes both ‘name-brand’ services (e.g., Home Builders, Multidimensional Family Treatment, Multisystemic Treatment) and more generic HBFT services, yet most HBFT programs have comparable programdesigns (Lee et al., 2014). Moreover, recent research has shown that different home-based programs are more alike than unique (Visscher et al., 2020). One main common characteristic is that care is provided in the family’s home environment, providing the care worker with the opportunity to better understand and accommodate treatment to the family’s everyday reality (Assen et al., 2020; Waisbrod, 2012). Another important common characteristic is the systemic approach focusing on the family system to optimize the child’s development by promoting family functioning, parental competencies, and the family’s self-reliance (ChildWelfare Information Gateway, 2014; Lee et al., 2014; Visscher et al., 2020).