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GENERAL INTRODUCTION 15 Finally, there is but scarce evidence regarding the impact of enrolment in care, including its significance for outcomes of care. We therefore also aim to better understand the types and severity of problems present upon enrolment in psychosocial care, i.e. child, parenting and family problems, as well as assessed outcomes, i.e. care duration and problem solution, after three and twelve months. Evidence shows that psychosocial care does not solve all psychosocial problems of children and adolescents [30, 37-40]. Given the serious impact of psychosocial problems on the lives of children and families, greater insight into factors associated with effectiveness of care is urgently needed. The process of enrolment may play a crucial role in this. Context in which the study was conducted: C4Youth and TakeCare This study took place within the Collaborative Centre on Care for Children and Youth (C4Youth), a collaborative academic centre in the northern Netherlands aimed at care for children and adolescents with psychosocial problems. A collaborative academic centre is a knowledge-centred infrastructure involving research, practice, education and policy in long-term collaboration to enhance the quality of care. The Netherlands Organization for Health Research and Development (ZonMw) has been financing such centres since 2008. C4Youth was the first of these. The primary goal of C4Youth is to promote an exchange of knowledge between the realms of research, practice, education and policy [41]. Its second goal is to collect evidence on the functioning of the entire chain of care for children and adolescents, and on long-term outcomes. This is done via the longitudinal prospective cohort study called TakeCare (Tracing Achievements, Key processes and Efforts in professional care for Children and Adolescents REsearch) [20]. The aim of this major cohort study is to augment evidence on children’s and adolescents’ enrolment in psychosocial care, on the various types of care offered to them, and on the outcomes of this care. The TakeCare study covers three research themes, each comprising different aspects of the care process (Figure 1): enrolment in care, contents of care, and client- professional communication. The first theme, enrolment in care, is the main topic of this thesis, and focuses on children’s and adolescents’ enrolment in psychosocial care , its association with subsequent care, and care outcomes. The second theme focuses on the contents of care actually provided for children and adolescents with psychosocial problems, and their families [17]. The third theme focuses on the role of client- professional communication: how clients perceive communication, its associations with care outcomes, and what actually happens during client-professional encounters [42]. The database resulting from the TakeCare study provides information on the psychosocial care offered to children and adolescents as seen from the perspectives of