Background: Youth care is rediscovering the relevance of community-based work in the ecology of youngsters in terms of preventive strategies. This movement towards the community is 'used' to get in touch with ‘hard-to-reach’-youngsters who are perceived to be 'at risk' on different life domains. However, there is little scientific knowledge on the support needs as defined by the youngsters themselves, although their voice is an indispensable perspective in ‘problem definition’ and consequent tailoring and adapting interventions and strategies to the youngsters' support needs. Recently, 'continuity of care' is put forward by policy makers as a concept that can improve the quality of youth care interventions. Despite the acceptance that continuity of care is an important topic, the concept itself seems to lack clarity (Heaton, Corden, & Parker, 2012). Also, its relationship to 'accessibility of care' and 'transition within or out of youth care' are still issues for debate (McNicholas et al., 2015).
Objective: In this presentation, we aim at gaining insight in the conceptualization of continuity of youth care from the perspective of youngsters living in vulnerable situations. We will argue that rhythm is an important concept in relation to continuity of care. The study is part of a more comprehensive PhD-project, in which different perspectives on continuity and coordination of care are compared.
Method: The participating youngsters received case management provided by youth welfare services in Ghent (Flanders), which are situated in the vulnerable areas of the city, characterized by poverty, small housing, ethnic diversity and few opportunities for youngsters. Many of the participants experienced difficulties on several life domains. In-depth interviews were carried out. To guide these open interviews, a model of continuity developed in the context of general practice in the UK was used as a sensitizing conceptual framework. Interpretative Phenomenological Analysis (IPA) was used to guide the interview process as well as the analysis of the data.
Results: The preliminary results show that each trajectory is perceived as a 'road with complex twists and turns'. The participants underscore the importance of significant relationships with people in their community to connect with "the outside world". Reaching a shared problem definition seems to be a balancing exercise, in which appropriate space to match different views is essential for a continuing and rewarding relationship. An 'interactional acceptance process' seems to take place between the youngster and the 'significant other', who provides support. In this sense, 'support' is never just 'support' or 'care'. Rather, it is conceived as a constructed reality within the interactional trajectory, where the interaction itself is a continuous exercise in mutual acceptance.
Engagement from adults, within their communities and within more systemic youth care, is mentioned as a major issue. This engagement is described as an authentic 'reaching out' and 'listening' to the lived experience of youngsters themselves, without a prefixed agenda or problem definition at hand. The idea of having someone who can be trusted, and whom they recognize as 'one of them' and 'watching their back' seems very important.
Discussion: Different 'rhythms', such as the perceived rhythm of the youngsters themselves in relation to the rhythm of the service provision, seem to be important. Problems mentioned by youngsters relate to the inability of services to match appropriately to the rhythm of the youngster. The stories disclose that this is often perceived a difficult aspect in youth care, because of the unpredictable nature of the process of care. During the presentation, we will reflect on rhythm as a central concept of care trajectories and look at implications for youth care interventions.
Key words: community-based care, ecology, youth care, vulnerable youth, continuity of care
Migration and minorities in child welfare , Participation of children and families in child welfare interventions
