The effectiveness of institutional youth care over the past three decades: a meta-analysis

A meta-analysis of 27 controlled studies, including 17,038 youth, was conducted to examine the effectiveness of institutional youth care over the past three decades. We compared institutional evidence-based treatment (EBT) with non-institutional EBT, institutional care as usual (CAU) with non-institutional CAU, institutional CAU with non-institutional EBT, and institutional EBT with institutional CAU. Only the last comparison yielded a significant and small-to-medium effect (d = .36), which not only shows that institutional youth care can be equally effective as non-institutional youth care, but also demonstrates that it seems more effective to provide youth with EBT during their stay in the institution. Furthermore, moderator analyses indicated that only cognitive behavior therapy showed a significant and medium effect (d = .50), whereas (social) skills training and care as usual showed no effect. Age, gender, type of outcome measure (delinquency, skills, problem behavior, and overall problems) and study design characteristics (randomized, matched or non-matched controls) did not influence the results.